术后不同放化疗时机对局部进展期宫颈癌患者预后和生存质量的影响

目的:比较术后不同放化疗时机对局部进展期宫颈癌患者预后和生存质量的影响。方法:回顾性收集我院收治的局部进展期宫颈癌患者124例，根据患者术后放化疗时机将患者分为观察组(n=56，手术至开始放化疗时间≤6周)和对照组(n=68，手术至开始放化疗时间>6周)，观察两组患者近远期临床疗效。结果:与对照组比较，观察组患者术后3年时复发率显著降低(35.71% vs 55.88%，P=0.025)；死亡率显著降低(21.43% vs 44.12%，P=0.008)。术后3年时观察组完全缓解、部分缓解、病情稳定和疾病进展的例数分别为36、4、2和14例，对照组分别为30、5、2和31例，差异有统计学意义(P=0.017)。两组患者术前生存质量(SF-36)差异无统计学意义(P>0.05)。术后3个月和6个月时观察组生存质量(SF-36)均高于对照组(P<0.05)。结论:局部进展期宫颈癌术后早期放化疗有助于降低术后复发率和死亡率，改善患者生存质量。

Comparison of the effects of different postoperative chemoradiotherapy time on the prognosis and quality of life in locally advanced cervical cancer patients

Objective:To compare the effects of different postoperative chemoradiotherapy timing on the prognosis and quality of life in locally advanced cervical cancer patients.Methods:124 cases of locally advanced cervical cancer patients were collected in our hospital.According to the timing of postoperative chemoradiotherapy，all patients were divided into an observation group (n=56，the time to start chemoradiotherapy after the operation ≤ 6 weeks) and a control group (n=68，the time to start chemoradiotherapy after the operation>6 weeks).The short and long-term clinical efficacy of the both groups were compared.Results:When compared with the control group，patients in the observation group got a decreased recurrence rate at 3 years after the operation (35.71% vs 55.88%，P=0.025).A lower rate of mortality (21.43% vs 44.12%，P=0.008).At three years after operation，the number of complete remission，partial remission，stable disease and progression of disease in the observation group were 36，4，2 and 14，while they were 30，5，2 and 31 in the control group respectively，and the difference was statistically significant (P=0.017).There was no significant difference in preoperative health-related quality of life (SF-36) between the two groups (P>0.05).The health-related quality of life (SF-36) in the observation group at 3 months and 6 months after the operation were both higher than that in the control group (P<0.05).Conclusion:Early postoperative chemoradiotherapy in locally advanced cervical cancer patients is helpful to reduce postoperative recurrence rate and mortality，and improve the quality of life.