早期高危子宫颈癌同步放化疗76例

目的 探讨同步放化疗治疗早期高危子宫颈癌的疗效及患者的不良反应.方法 将76例病理确诊的ⅠB2～ⅡA期子宫颈癌患者按入院顺序随机分成同步放化疗组(A组)和单纯放疗组(B组),A组41例(ⅠB2期20例,ⅡA期21例),B组35例(ⅠB2期18例,ⅡA期17例),两组均采用直线加速器6 MV-X射线根治性放射治疗,外照射DT45 Gy,腔内治疗采用192Ir后装机,A点7 Gy/周,总剂量为35～42 Gy,A组在放疗第1周、第4周同步行化疗:顺铂(DDP)20 mg第1天至第5天,5-氟尿嘧啶(5-Fu)500mg第1天至第5天,亚叶酸钙(CF)100mg第1天至第5天,第7周重复一次化疗.观察近期疗效、5年生存率及放疗、化疗并发症.结果 放疗后3个月两组有效率分别为97.5%(CR 37例,PR3例)、80.0%(CR 24例,PR 4例),两组间差异有统计学意义(P＜0.05);A组5年生存率(70.7%)明显高于B组(60.0%)(P＜0.05);A组患者的不良反应高于B组,但均能耐受;放疗远期并发症并未增加.结论 同步放化疗能提高早期高危子宫颈癌患者的疗效及生存率,且安全可靠.

Clinical study on concurrent chemoradiotherapy for high-risk early stage cervical cancer

Objective　To investigate the effect and side effect of concurrent chemoradiotherapy for high-risk early stage cervical cancer. Methods　The treatment group(group A) included 41 and the control group(group B) included 35 cases of ⅠB2 ～ⅡA cervical carcinoma pathologically verified. The 6MV-X ray was used for external radiation with a total dose of 45 Gy. 192Ir afterloading unit was used for brachytherapy at the dose of 7 Gy per week at point A with a total dose of 35～42 Gy. The group A patient was synchronously given DDP 20 mg d1～5, 5-Fu 500 mg d1～5, CF 100 mg d1～5 at the first, fourth and seventh week respectively. Short-time effect, 5-year survival and complications were observed. Results　The effective rate of 3 months after radiotherapy was 97.5 % in group A and 80.0 % in group B, showing a significant difference (P <0.05) respectively. 5-year survival rate was higher in group A(70.7 %) than in group B (60.0 %)(P <0.05). Complications in group A were higher in group B, but they could be tolerable and without additional long-term complications. Conclusion　Concurrent chemoradiotherapy can remarkably increase the survival rate of high-risk early stage cervical carcinoma.