化疗和放疗联合治疗中晚期宫颈癌疗效分析

目的对比化疗配合放射治疗与单纯放疗治疗宫颈癌的疗效，探讨综合治疗在中晚期宫颈癌中的疗效及安全性。方法100例Ⅱ～Ⅲ中晚期宫颈癌患者分成两组，放疗同步化疗（A组）50例，在放疗同时给予PVB或PF方案化疗2～4周期，化疗第1天开始行放射治疗。单纯放疗组（B组）50例，两组放射治疗均用15MV—X线盆腔大野前后对穿体外照射，DT：45～50Gy；并加坶。IrHDR腔内后装照射，A点DT：20-25Gy。结果A组和B组近期有效率分别为94．0％和74．0％，两组的差异有显著性意义（P〈0．01）。A组和B组的3年生存率分别为76．0％和48．0％，差异有显著性意义（P〈0．05）。毒性反应方面，同步化放疗组高于单纯放疗组，尤以造血系统和消化道反应为主，但大部分能够耐受。结论中晚期宫颈癌患者PVB或PF方案同步放化疗可提高局部控制率和提高生存率。

Analysis of efficacy of chemotherapy combined with radiotherapy in middle and advanced cervical cancer

Objective To evaluate the efficacy and acute toxicity of chemotherapy combined with radiotherapy in middle and advanced cervix cancer. Methods 100 patients with stage Ⅱ-Ⅲ cervix cancers were randomized into A group （chemotherapy plus radiotherapy group） and radiotherapy alone group. They got exter beam and brachtherapy for total dose 65 -75Gy. Radiotherapy in both groups was administered with one -daily external irradiation doses of 1.8 -2Gy to the pelvis, 5d/wk and brachytherapy to deliver a total dose of 20 -25Gy to point A. Two groups underwent the same fractionation irradiation, the chemo - radiotherapy group was given PVB or PF regimen. Results The efficacy rates of the two groups were 94.0% （ A group） and 74. 0% （ B group）, there was statistical difference （ P 〈 0.01 ）. The 3 year survival rate was 76.0% in A group and 48.0% in B group （P 〈 0. 05）. More severe toxicity was found in the group of concurrent chemotherapy plus radiotherapy. Most of them was tolerable. Conclusions The concurrent PVB or PF chemotherapy plus radiotherapy for middle and advanced cervical cancer can significantly improve survival without significantly increasing side effects.