同步放化疗治疗中晚期宫颈癌366例临床分析

目的：评价同步放化疗治疗中晚期子宫颈癌的作用。方法：选择2000年10月～2003年5月我科收住的子宫颈鳞癌患者366例，随机分为2组：单纯放疗组188例，采用体外照射加腔内治疗，体外全盆外照DT 30Gy，四野外照DT25Gy，腔内治疗A点剂量DT 70Gy以上，7～8周完成。同步放化疗组178例，放疗开始给予全身静脉化疗，化疗方案为DDP＋VCR＋BLM，化疗3周期，每28天重复治疗。结果：同步放化疗组与单纯放疗组有效率分别为87．08％、55．32％，2组近期疗效差异有统计学意义（P〈0．05）。同步放化疗组与单纯放疗组的2年生存率分别为为70．6％、56．7％，差异有统计学意义（P〈0．05）。同步放化疗组骨髓抑制及消化道反应发生率均高于单纯放疗组（P均〈0．05）。及时对症治疗后，患者均可耐受治疗。远期直肠膀胱并发症并未增加。结论：同步放化疗治疗中晚期子宫颈癌可提高近期疗效及2年生存率。以铂类为基础的化疗疗效肯定，患者能耐受，与化疗联合应用安全、合理。

Concurrent chemotherapy plus radiotherapy for advanced cervical cancer

Objective: To assess the effect of concurrent chemotherapy plus radiotherapy for treatment advanced cervical cancer. Methods: Three hundred and sixty-six patients with advanced cervical cancer were randomized into two groups:Radiotherapy alone group (188 patients) received whole pelvic field plus four field radiotherapy combined with intracavitary irradiation for 70 Gy at point A and 55Gy at point B. Concurrent radiotherapy plus chemotherapy, one cycle per 4 weeks,total 3 cycles. Results: In the group of radiotherapy alone, the response rate was 55. 32% and the 2-year survival rate was 56. 7%. In the group of concurrent radiotherapy plus chemotherapy, the response rate was 87. 08% and the 2-year survival rate was 70. 6%. There were significant differences in two groups (P <0. 05). More serious toxicity was found in the group of concurrent radiotherapy plus chemotherapy, but it was tolerable. Conclusions: Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 2-year survival rate and it was better-tolerated in toxicity.