局部晚期宫颈癌同步放化疗临床观察

目的探讨同步放化疗治疗局部晚期宫颈癌的疗效和不良反应。方法 80例经病理确诊、临床分期为Ⅱb~Ⅲb期局部晚期宫颈癌患者随机分成两组,每组各40例,均予根治性放疗,体外放疗均采用直线加速器15 MV X射线,DT46~50 Gy,腔内治疗采用192Ir后装机,A点6 Gy/周,总剂量为36~42 Gy。两组放疗方法相同,同步放化疗组在放疗前每周日加用多西紫杉醇(希存)40 mg静滴,共6周。观察近期疗效、3年生存率及放化疗并发症。结果放疗后3个月同步放化疗组有效率(100%)明显高于单纯放疗组72.5%(P<0.05),局部复发率、远处转移率两组分别为5.0%、2.5%和17.5%、15.0%,差异有统计学意义(P<0.05);3年生存率分别为82.5%和55.0%(P<0.05),而毒副作用无明显增加(P>0.05)。结论同步放化疗能提高局部晚期宫颈癌患者的疗效及生存率,降低局部复发率及远处转移率。

Clinical observation on concurrent chemoradiotherapy for locally advanced cervical cancer

Objective To investigate the effectiveness and side effects of concurrent chemoradiotherapy for locally advanced cervical cancer.Methods Eighty patients with pathologically verified Ⅱb-Ⅲb cervical cancer were randomly divided into two groups,each group had 40 cases.Both groups underwent radiotherapy,using 15 MV X ray for external radiation with a total dose of 46-50 Gy and 192Ir afterloading unit for brachytherapy at the dose of 6 Gy per week at point A with a total dose of 36-42 Gy.Radiotherapy in both groups was performed with the same method,only in concurrent chemoradiotherapy group,docetaxel 40 mg dripping before radiotherapy once every week for 6 weeks was added.The short-term efficacy,3-year survival rate and the side effects were observed and compared.Results The effective rate 3 months after radiotherapy was 100% in concurrent chemoradiotherapy group and 72.5% in radiotherapy group,showing a significant differrence（P0.05）,local recurrence and distant metastasis was 17.5% and 15.0% respectively in radiotherapy group,higher than in concurrent chemoradiotherapy group（5.0%and 2.5%）（P0.05）.The 3-year survival rate was higher in concurrent chemoradiotherapy group（82.5%）than in radiotherapy group（55.0%）（P0.05）.The side effects of the two groups were about same（P0.05）.Conclusion Concurrent chemoradiotherapy can remarkably increase the effectiveness and the survival rate in patients with locally advanced cervical cancer.