论文部分内容阅读
目的评价同期放疗加化疗治疗中晚期宫颈癌的长期疗效及放化疗副反应。方法 2002年2月至2003年8月在南京医科大学附属淮安市第一人民医院将120例初治中晚期宫颈癌随机分为放化组60例及放疗组60例。放化组采用顺铂40mg/m2,放射治疗期间每周化疗1次,共6次。两组的放疗方法及剂量相同,均用全盆四野外照,DT40Gy,每周5次(与腔内放疗同时进行时,外照射每周4次),Ⅱb期盆壁野加量至54Gy,Ⅲ、Ⅳa期加量至60Gy。同时或外照射后接着Ir腔内放疗,A点剂量DT42Gy/7次。结果所有病人均顺利完成治疗。放化组和放疗组的近期完全消退率分别为83.3%和53.3%,差异有统计学意义(P=0.000),放化组和放疗组的1、3、5年生存率分别为83.3%、71.6%、66.7%,和76.7%、53.3%、45%,两组差异有统计学意义(χ2=5.37,P=0.021)。放化组和放疗组的1、3、5年无病生存率分别为81.7%,65%、55%,和70%、45%、33.3%,两组差异有统计学意义(χ2=5.96,P=0.015)。放化组的急性反应较放疗组重(χ2=3.84,P=0.05)。结论采用顺铂同期放化疗可以提高中晚期宫颈癌的生存率和无病生存率。
Objective To evaluate the long-term efficacy of concurrent radiotherapy plus chemotherapy in the treatment of advanced cervical cancer and the side effects of radiotherapy and chemotherapy. Methods From February 2002 to August 2003, 120 cases of newly diagnosed middle-advanced cervical cancer were randomly divided into radiotherapy group (60 cases) and radiotherapy group (60 cases) at Huaian First People’s Hospital Affiliated to Nanjing Medical University. Radiotherapy group with cisplatin 40mg / m2, radiotherapy weekly chemotherapy 1, a total of 6 times. Radiotherapy methods and doses of the two groups were the same, all the four pots with a full basin of foreign, DT40Gy, 5 times a week (with intracavitary radiotherapy at the same time, external irradiation 4 times a week), Ⅱ b stage pelvic field dosage to 54Gy, Ⅲ, Ⅳa dosage to 60Gy. At the same time or external irradiation followed by Ir cavity radiotherapy, A dose of DT42Gy / 7 times. Results All patients successfully completed the treatment. The complete remission rates of radiotherapy group and radiotherapy group were 83.3% and 53.3%, respectively, with significant difference (P = 0.000). The 1, 3 and 5-year survival rates of radiotherapy group and radiotherapy group were 83.3% 71.6%, 66.7%, and 76.7%, 53.3% and 45%, respectively. There was significant difference between the two groups (χ2 = 5.37, P = 0.021). The 1, 3, 5 year disease-free survival rate was 81.7%, 65%, 55%, 70%, 45%, 33.3% respectively in radiotherapy group and radiotherapy group, with significant difference between the two groups (χ2 = 5.96, P = 0.015). The radiotherapy group had more acute reactions than radiotherapy group (χ2 = 3.84, P = 0.05). Conclusion Cisplatin concurrent chemoradiotherapy can improve the survival rate and disease-free survival rate of advanced cervical cancer.