放化疗治疗中晚期宫颈癌

目的观察化疗加放射治疗中晚期宫颈癌的疗效及不良反应,探讨治疗中晚期宫颈癌更有效的方法。方法64例中晚期宫颈癌患者分成化放组(32例)及单纯放射治疗组(32例),化放组采用顺铂20mg静脉滴注1~5d,化疗2~3个周期,3周重复,同时进行根治性放射治疗,化疗第1d开始行放射治疗。放疗方法用6MV~8MVX线全盆外照DT 25~30Gy,四野DT 25~30Gy,192铱腔内照射6~7次、1次/周,每次5~6Gy,A点量70Gy左右,B点量50Gy~55 Gy。单纯放射治疗组剂量方法同化放组。结果外照射结束时两组的有效率分别为78.13%及65.63%,差别无显著性(P>0.05),放疗后3个月时两组的有效率分别为93.75%及62.5%,差异显著(P<0.05),两组患者3年生存率分别为84.38%、53.13%,差别有显著性(P<0.05)。化放组局部复发率,远处转移率明显低于单纯放疗组。同步放化疗组有较明显的骨髓抑制和消化道反应,但患者经治疗后均能耐受。结论化疗加放疗能明显提高患者的生存率,降低远处转移率。

Evaluation of Clinical Curative Effect of Combined Chemo- radiotherapy for Advanced Cervical Carcinoma

Objective To investigate the clinical curative effects and side effect of chemo-radiotherapy for advanced cervical carcinoma.To evaluate the efficacy of treatment of advanced cervical cancer.Methods 64 patients for medium-term and advanced cervical carcinoma were randomized into two groups chemo-radiotherapy group(32cases) and only radiotherapy group(32cases),each patient of the chemo-radiotherapy group was given cisplatin with hydration at the dose of 20mg daily intravenously for 1~5days once every 3 weeks for 2~3 cycles and radiotherapy was given at the same time6MV~8MV X ray was used for external radiation with a total dose(DT) of 25~30Gy and 25~30Gy for four fields,192 Ir afterloading unit was used for brachytherapy at the dose of 5~6Gy per time for total 6~7 times.The dose of A point and B point was 70Gy and 50~55Gy respectively.The patients of simple radiotherapy group were received radiotherapy with the same dose and methods.Results The effect rates of the chemo-radiotherapy and only radiotherapy groups were78.13% and 65.63% respectively at the end of the external radiotherapy with no difference significantly (P>(0.05)).3 months after radiotherapy the effect rates in both groups were 93.75% and 62.5% showing a significant difference(P<(0.05)).The 3 year survival rate were 84.38% and 53.13%(P<(0.05)).The rates of pelvic recurrence and distant metastasis in chemo-radiotherapy group were lower than that in simple radiotherapy group,more serious side effects were found in the chemo-radiotherapy group,especiously in bone marrow inhibition and reaction of digestive tract,which could be alleviated.Conclusion Radiotherapy and chemotherapy concurrently can obviously increase the survival rate and decrease the rate of the distant metastasis.