单纯放疗与以顺铂为主的同步放化疗治疗子宫颈癌的临床效果对比分析

目的对比分析单纯放疗及应用以顺铂为主的同步放化疗治疗宫颈癌初治患者的疗效和并发症。方法选择2000-2006年北京妇产医院收治的初治宫颈癌患者共197例,临床分期为Ⅰb-Ⅳa期,按治疗方法不同分为单纯放疗组（共100例,给予^60Co盆腔外照射及^192Ir腔内后装照射）和同步放化疗组（共97例,给予以顺铂为主的化疗,同步给予放疗,放疗方案与单纯放疗组相同）,对两组患者的疗效及并发症发生情况进行对比分析。结果单纯放疗组与同步放化疗组有效率分别为92％和89％,两组比较,差异无统计学意义（P=0．500）;其5年生存率分别为82％和79％,两组比较,差异无统计学意义（P=0．177）。单纯放疗组和同步放化疗组中Ⅲ期以上、病理分级G3、鳞癌患者的5年生存率分别为56％和84％,两组比较,差异有统计学意义（P〈0．01）;同步放化疗组和单纯组的近期并发症均以骨髓抑制为主,其中Ⅲ度以上骨髓抑制的发生率分别为14％和3％,两组比较,差异有统计学意义（P〈0．01）;其远期并发症的发生率分别为11％和8％,两组比较,差异无统计学意义（P=0．496）。结论应用以顺铂为主的同步放化疗治疗Ⅲ期以上、病理分级G3、鳞癌患者可明显提高其5年生存率。

Retrospective study of chemoradiotherapy based on cisplatin compared with radiotherapy alone for cervical cancer

OBJECTIVE: To compare the treatment effects and side events between chemoradiotherapy and radiotherapy alone for patients with primary cervical cancer. METHODS: Totally 197 patients with primary cervical cancer in our hospital from 2000 to 2006 were studied. They were divided into two groups: radiotherapy alone (RT) or cisplatin-based chemoradiotherapy (CRT). Group of RT included 100 patients who received external irradiation by (60)Co and intracavitary irradiation by (192)Ir. Group of CRT included 97 patients who received cisplatin-based chemoradiotherapy. The RT regimen was the same as group RT. RESULTS: The local control (CR + PR) in two groups had no statistic difference (P = 0.500). The total 5 year survival rate in the two groups were 82% and 79%, with no significant difference (P = 0.177); however, there was a significant difference for stage III squamous cell carcinoma of the cervix, the 5 year survival rate being 56% and 84%, respectively (P < 0.01). The common side effect was hematological toxicity in some patients, which was more serious in CRT group than in RT group. Grade 3 hematological toxicity were 3% and 14% (P < 0.01), although the long-term complications in two groups were not different (P = 0.496). CONCLUSION: Chemoradiotherapy based on cisplatin may be effective for stage III squamous cell carcinoma of the cervix.