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目的探讨外照射加腔内后装照射治疗宫颈癌的疗效及放疗并发症的治疗。方法回顾性分析1990年7月至2000年3月河南省肿瘤医院应用腔内后装放疗与体外照射相结合治疗子宫颈癌580例的临床资料。结果580例宫颈癌患者,I期2例(0.34%),Ⅱ期292例(50.34%),III期277例(47.76%),IV期9例(1.56%)。5年总的存活率为62.75%。临床Ⅱ、Ⅲ期中肿瘤直径≤4cm者5年存活率分别为73.91%及60.58%,明显高于直径>4cm患者的5年存活率40.32%及40.18%(P均<0.05)。Ⅱ、Ⅲ期治疗前血红蛋白<100g/L组的5年存活率分别为31.56%及29.60%,≥100g/L组的5年存活率分别为68.49%及68.59%,两组比较差异显著(P均<0.01)。临床II期中病理分级Ⅱ级者5年存活率为75.00%,Ⅲ级者为58.60%,两者比较差异显著(P<0.05)。放射性膀胱炎和放射性直肠炎的发生率分别为3.97%和5.0%。结论影响外照射加腔内后装照射治疗宫颈癌预后的因素是肿瘤期别、大小,治疗前血红蛋白水平及病理分级。外照射加腔内后装照射治疗宫颈癌疗效肯定,晚期并发症发生率较少。
Objective To investigate the curative effect of radiotherapy and radiotherapy combined with external irradiation plus intracavitary after irradiation on cervical cancer. Methods A retrospective analysis of clinical data of 580 cases of cervical cancer treated by endovascular radiotherapy combined with external beam irradiation in Henan Tumor Hospital from July 1990 to March 2000 was retrospectively analyzed. Results Among 580 cases of cervical cancer, there were 2 cases in stage I (0.34%), 292 cases (50.34%) in stage II, 277 cases (47.76%) in stage III and 9 cases (1.56%) in stage IV. The 5-year overall survival rate was 62.75%. The 5-year survival rates of patients with tumor diameter less than or equal to 4cm in stage II and III were 73.91% and 60.58% respectively, which were significantly higher than 40.32% and 40.18% respectively (P <0.05). The 5-year survival rates of group Ⅱ and Ⅲ before treatment were 31.56% and 29.60%, respectively. The 5-year survival rates of group ≥100g / L were 68.49% and 68.59%, respectively All <0.01). The clinical grade II grade II had a 5-year survival rate of 75.00% and grade III of 58.60%, with significant difference between the two groups (P <0.05). The incidence of radiation cystitis and proctitis were 3.97% and 5.0%, respectively. Conclusion The factors influencing the prognosis of cervical cancer after external irradiation plus intracavitary rear irradiation are tumor stage, size, hemoglobin level before treatment and pathological grade. Radiation plus intracavitary after radiation therapy for the treatment of cervical cancer certainly, the incidence of late complications less.