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目的:回顾性分析同步推量调强放疗联合化疗治疗局部中晚期宫颈癌的临床疗效和安全性。方法 :研究对象为2012年1月—2014年1月在暨南大学附属第一医院接受治疗的局部中晚期宫颈癌患者92例,其中研究组68例接受同步推量调强放疗联合紫杉醇脂质体和洛铂同步放化疗,对照组24例接受三维适形放疗联合紫杉醇脂质体和洛铂同步放化疗。比较2组的临床疗效、生存情况和安全性。结果 :研究组临床总有效率为85.29%,显著优于对照组的58.33%(P=0.022)。研究组患者的中位生存期为31个月,明显优于对照组患者的25个月。研究组患者的骨髓抑制发生率低于对照组,差异有统计学意义(P=0.041)。研究组患者的胃肠反应发生率与对照组相比,差异无统计学意义(P=0.704)。研究组患者的放射性直肠炎和膀胱炎发生率明显低于对照组,差异有统计学意义(P值分别为0.001和0.018)。结论 :同步推量调强放疗联合化疗治疗局部中晚期宫颈癌患者的疗效显著,患者耐受性较好,不良反应较轻,值得在临床上进行推广。
OBJECTIVE: To retrospectively analyze the clinical efficacy and safety of concurrent push-boost IMRT combined with chemotherapy in the treatment of locally advanced cervical cancer. Methods: The study included 92 patients with locally advanced cervical cancer who were treated in the First Affiliated Hospital of Jinan University from January 2012 to January 2014, in which 68 patients in the study group underwent simultaneous metered dose intensity modulated radiotherapy and paclitaxel liposomes and Los platinum synchronous chemoradiation, the control group of 24 patients underwent three-dimensional conformal radiotherapy combined with paclitaxel liposomes and lobaplatin concurrent chemoradiation. The clinical efficacy, survival and safety of the two groups were compared. Results: The total clinical effective rate was 85.29% in the study group, which was significantly better than 58.33% in the control group (P = 0.022). The median survival of the study group was 31 months, significantly better than that of the control group for 25 months. The incidence of myelosuppression in the study group was lower than that in the control group, with a significant difference (P = 0.041). The incidence of gastrointestinal reactions in the study group was not significantly different from that in the control group (P = 0.704). The incidence of radiation proctitis and cystitis in the study group was significantly lower than that in the control group (P = 0.001 and 0.018, respectively). Conclusions: The simultaneous curative effect of intensity-modulated radiotherapy and chemotherapy combined with chemotherapy for locally advanced cervical cancer patients is remarkable. The patients are well tolerated and the adverse reactions are mild. It is worth to be popularized clinically.