热疗联合放化疗治疗局部晚期子宫颈癌的临床分析

目的评价深部聚焦热疗联合放化疗治疗局部晚期子宫颈癌的近期临床疗效及患者不良反应。方法收集局部晚期子宫颈癌患者68例，其中热疗与放化疗联合组30例，放化疗对照组38例，化疗采用FP方案，每周2d，连用3周，放疗采用常规分割，热疗采用深部聚焦热疗机，提升肿瘤局部温慧达42．5℃以上并维持至少30min，每周2次，共7～12次，均于放疗结束后2h内进行。两组均于放疗剂量达40Gy后根据妇科检查及超声结果进行判断，可手术者行根治术，仍无手术指征者追加外照射及^252Cf源后装治疗至根治量。结果所有患者均完成了治疗，联合组手术切除率50．0％（15／30），高于对照组的26.3％（10／38）（P〈0．05）；联合组的局部有效率为90．0％（27／30），对照组为84．2％（32／38）（P〉0．05）；联合组的不良反应未高于对照组。结论热疗联合放化疗可以提高局部晚期子宫颈癌患者的手术切除率及局部控制率，不增加放射反应，可提高患者生活质量。

Hypothermia combined with chemoradiotherapy in treatment of local advanced cervical cancer

Objective To evaluate the efficacy and toxicity of hyperthermia combined with chemoradiotherapy for local advanced cervical cancer. Methods Sixty-eight patients with local advanced cervical cancer were treated. Each patient was given cisplatin at the dose of 20 mg ivgtt dl -2 and 5 -fluorouracil 0.75 ivgtt dl -2, repeating every week, total 3 weeks. Thirty -eight patients received chemoradiotherapy alone. Thirty patients received hyperthermia with deeply focus technology, the temperature was increased and maintained 42.5 ℃ for 30 min at least, within 2 hours following irridiation. Hyperthermia was given twice per week with 7 or 12 sessions, as the same chemoradiation methods as the reference group.After 40 Gy therapy to estimate by cervical examination and ultrasonography, the patients with down stage were for operation, and the others continued to irridiation and additional brachytherapy with californium 252until radical dose. Results All patients were tolerated, fifteen patients of hyperthermia combined group were operated and ten patients of the reference group were operated, the difference was significance (50.0 % vs.26.3 %, P <0.05). The response rate of the combined group was 90.0 %, and the reference group was 84.2 %.The incidence of radiotherapy toxicity of the combined group was not higher than the reference group.Conclusion Hyperthermia combined with chemoradiotherapy can elevate the resection rate and the local control rate, not increase the radiotherapy toxicity and increase quality of life for cervical cancer patients.