区域性热疗联合化疗治疗局部复发宫颈癌的疗效观察

目的 观察区域性热疗联合化疗治疗局部复发宫颈癌的疗效及不良反应.方法 自2008年3月至2010年7月64例局部复发宫颈癌按治疗模式的不同分成2组,单纯化疗组与热化疗组,化疗采用CPT-11 160mg/m2,d1;DDP 80mg/m2,d1,每3周重复,共2周期.热疗输出功率为1200W-1000W,以直肠进行测温,温度恒定在40.5℃-41.5℃,恒温治疗时间40min左右,2次/周,每次间隔72小时,8次/疗程.化疗同时行热疗,不行化疗时常规行热疗.结果 单纯化疗组有效率为36.6%,热化疗组有效率为61.7%(P<0.05);单纯化疗组III+IV度白细胞减少发生率明显高于热化疗组,(P<0.05);热化疗组未出现严重不良反应.结论 区域性热疗联合伊立替康+顺铂化疗局部复发宫颈癌,近期疗效确切、不良反应轻,且可减轻化疗不良反应,值得进一步推广应用,其远期疗效有待进一步观察.

Efficacy of regional hyperthermia combined with chemotherapy for patients with locally recurrent cervical cancer

Objective:To observe the efficacy and adverse reactions of regional hyperthermia combined with chemotherapy for patients with locally recurrent cervical cancer.Methods: From March 2008 to July 2010,64 patients with locally recurrent cervical cancer were divided into two groups,the chemotherapy alone group and thermo-chemotherapy group.The chemotherapy regiem was used by CPT-11 160mg/m2,d1 with DDP 80mg/m2,d1,once 3 weeks,with a total of 2 cycles.The deferent power of hyperthermia was 1200W-1000W.The temperature was detected by the sensor in rectum.The hyperthermia constant was at 40.5℃-41.5℃,the constant treatment time was about 40min,twice a week,at intervals of 72 hours,8 times a course.When chemotherapy was conformed,regional hyperthermia was performed simultaneously,but when chemotherapy was not conformed,regional hyperthermia was performed alone.Results: The effective rate(CR+PR)of chemotherapy alone group was 36.6%,but the thermo-chemotherapy group was 61.7%(P<0.05).III+IV degree white blood cell shortage was much more in the chemotherapy alone group than that in thermo-chemotherapy group(P<0.05).There were no seriously adverse reactions in thermo-chemotherapy group.Conclusion: Regional hyperthermia combined with irinotecan plus cisplatin chemotherapy for locally recurrent cervical cancer was effective,and the adverse reactions were slight.Regional hyperthermia could reduce the side effects of chemotherapy.It deserves further to be applied in wide scope,and its long-term effects need to be further observed.