Ⅰ、Ⅱ期宫颈癌术后放射治疗37例分析

目的:观察宫颈癌术后放疗的疗效和并发症,探讨宫颈癌术后放疗的作用。方法:对我院1990年1月~2001年12月的37例手术后行放射治疗的宫颈癌患者,通过观察计算其5年生存率,观察治疗并发症等以观察术后放疗的效果。术后放疗方法包括单纯腔内治疗(8例)、单纯体外照射(10例)或体外、腔内联合放疗(19例)。37例中,Ⅰa期8例(21.6%),Ⅰb期12例(32.4%),Ⅱa期8例(21.6%),Ⅱb例(24.3%)。结果:37例中5年生存率为67.6%,其中Ⅰa期为87.5%,Ⅰb期为66.7%,Ⅱa期为62.5%,Ⅱb期为55.6%。治疗后阴道残端复发2例,盆腔复发6例,远处转移2例。术后放疗并发症有:放射性膀胱炎2例(发生率5.4%),放射性直肠炎4例(发生率10.8%),其中直肠阴道瘘1例(发生率2.7%)。结论:高危型Ⅰ、Ⅱ期宫颈癌术后放疗有一定的并发症发生,且疗效仍偏差,尤其是手术范围不够的情况下术后放疗不能显著提高患者的生存率。对于这些病例的治疗方案尚待进一步的研究。

Outcome of radiotherapy after surgery for cervical cancer stage Ⅰ - Ⅱ

Objective:To evaluate the efficacy and toxic of combined therapy of cervical cancer stage Ⅰ-Ⅱ by surgery and followed radiotherapy.Methods:Radiotherapy after surgery was administered to 37 patients with cervical cancer stage Ⅰ-Ⅱ in Beijing Obstetrics and Gynecology Hospital from 1990 to 2001.There were 8 cases in stage Ⅰa,12 cases in stage Ⅰb,8 cases in stage Ⅱa,9 cases in stage Ⅱb.8 patients were treated with after loading system alone,10 cases with 60Co external radiation therapy alone,and 19 cases with intracavitary therapy combined external radiation therapy.Results:The overall 5-year survival rate was 67.6%,with 87.5% for stage Ia,66.7% for stage Ⅰb,62.5% for stage Ⅱa and 55.6% for Ⅱb.There are 8 cases relapsed in the local and 2 cases metastasis elsewhere.There are 2 cases with radiation cystitis and 4 cases radiation rectitis in all cases,including one fistula of rectum-vagina.Conclusion:The effects of surgery followed by radiotherapy were poor for cervical cancer stage Ⅰ-Ⅱ,and there are some side effects including radiation cystitis and radiation rectitis,especially when the insufficient operation were made.