同步放化疗治疗中晚期宫颈癌

 目的 观察化疗联合放疗治疗中晚期宫颈癌的临床疗效和毒副作用。方法 58例中晚期宫颈癌患者随机分成化放组（29例）及单纯放疗组（29例），化放组采用顺铂25mg／m² d1-3，静脉点滴，5-Fu 350mg／m² d1-5静脉点滴，每4周重复，共3个周期，同时进行根治性放疗，化疗第1天开始进行放射治疗。用10MVX线体外全盆照射DT38-40Gy，中间铅挡后照射致宫旁剂量DT50-55Gy，第3周开始行¹⁹²Ir腔内照射，6Gy／次／天／周，A点剂量6Gy，B点剂量5Gy，共6～7次。单纯放射治疗组仅行单纯放疗，方法同化放组，不行化疗。结果于放疗结束时两组有效率分别为96．6％及86．2％，差异无显著（P〉0．05）。放疗后3个月时两组的有效率分别为96．6％及65．5%，差异显著（P〈0．05）。放化组3、5年生存率和无瘤生存率分别为79．3％、68．9％、62．1％，高于单放组的62．1％、51．7％、41．4％，差异显著（P〈0．05），随访5年，化放组的盆腔复发率为17．2％，低于单放组的31．0％，P〈0．05。化放组有较明显的骨髓抑制和消化道反应，但患者经治疗后均可耐受。结论化疗联合放疗治疗中晚期宫颈癌可增强疗效，副作用稍增加，但患者能耐受。

Prospective Trial for Concurrent Chemoradiotherapy Treatment in Medium-term and Advanced Cervical Carcinoma

Objective 　To investigate the clinical curative effects and side effects of chemoradiotherapy for medium-term and advanced cervical carcinoma. Methods 　Fifty-eight patients of medium-term and advanced cervical carcinoma were randomly divided into two groups : chemoradiotherapy group s and only radiotherapy group. Each patient s of the chemoradiotherapy group was given cisplatin at the dose of 25mg/ m² ivgtt d1-3 ,5-Fluorouracil ,350mg/ m² ivgtt ,d1-5 , repeat every 28 days , total 3 cycles. And radiotherapy was give at the same time , 10 MVX ray was used for external radiation with a total dose of 38～40 Gy ;then the middle field is shielded by plumbum , continuous radiotherapy to total dose of 50～55 Gy ;192 Irhigh-dose-rate af ter loading unit was used for branchytherapy after 3 weeks of external radiotherapy at the dose in A point of 6 Gy per time for total 6～7 times. The patients of radiotherapy group were only received radiotherapy with the same dose and same methods. Results 　The effect rates of the chemoradiotherapy group and radiotherapy group were 96. 6 % and 86. 2 % respectively at the end of the radiotherapy with no difference significantly ( P > 0. 05) ; Three months after radiotherapy the effect rates in both groups were 96. 6 % and 65. 5 % ,showing a significant difference ( P < 0. 05) . The overall 32year ,52year survival rates for the patients in chemoradiotherapy group and radiotherapy group were 79. 3 % ,68. 9 % and 62. 1 % ,51. 7 % respectively , P < 0. 05. Disease-free survival rates were 62. 1 % and 41. 4 % respec-tively , P < 0. 05. Pelvic recurrence rates were 31. 0 % and 17. 2 % respectively P < 0. 05. More serious side effects were found in the chemoradiotherapy group. Especially in bone marrow inhibition and reaction of digestive tract , Which could be alleviated. Conclusion 　Concurrent chemotherapy and radiotherapy in medium-term and advanced cervical carcinoma can increase t reatment effect and raise the survival of the patients ,obviously improve the short-term curative effect . Toxicity of patients was increasing but the patients could tolerate.