国际肿瘤学杂志 ›› 2016, Vol. 43 ›› Issue (6): 428-432.doi: 10.3760/cma.j.issn.1673-422X.2016.06.007

• 论著 • 上一篇    下一篇

单纯放疗与同步放化疗治疗宫颈癌患者的临床疗效

秦晓玲,贾玉玲,宝莹娜   

  1. 010050 呼和浩特,内蒙古医科大学附属医院放疗科
  • 收稿日期:2015-09-17 出版日期:2016-06-08 发布日期:2016-04-27
  • 通讯作者: 贾玉玲 E-mail:jiayuling.love@163.com
  • 基金资助:

    内蒙古自治区科技计划(20130403)

Curative effects of pure radiotherapy and concurrent chemotherapy and radiotherapy for patients with cerical cancer

Qin Xiaoling, Jia Yuling, Bao Yingna   

  1. Department of Radiation Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China  
  • Received:2015-09-17 Online:2016-06-08 Published:2016-04-27
  • Contact: Jia Yuling E-mail:jiayuling.love@163.com
  • Supported by:

    Science and Technology Project of Inner Mongolia of China (20130403)

摘要: 目的 探讨单纯放疗、同步放化疗治疗宫颈癌患者的疗效及不良反应。方法 研究对象为2010年5月—2012年5月在内蒙古医科大学附属医院接受治疗的127例宫颈癌患者。根据治疗方案分为两组:单纯放疗组65例,同步化放疗组62例。观察两组患者的疗效、不良反应和生存情况。结果 全组患者均顺利完成治疗,中位随访时间为42个月。单纯放疗组完全缓解率为80.00%(52/65),同步化放疗组完全缓解率为82.26%(51/62),差异无统计学意义(χ2=1.22,P=0.352)。单纯放疗组和同步放化疗组患者的1年总生存率分别为95.38%、95.16%,差异无统计学意义(χ2=0.32,P=0.533);3年总生存率分别为81.54%、90.32%,5年总生存率分别为72.31%、83.87%,差异均具有统计学意义(χ2=5.09,P=0.015;χ2=3.87,P=0.039)。46例年龄≥60岁的患者单纯放疗组和同步放化疗组1年总生存率分别为94.62%、93.91%,3年总生存率分别为85.02%、87.25%,5年总生存率分别为70.06%、73.58%,差异均无统计学意义(χ2=0.06,P=0.753;χ2=1.16,P=0.279;χ2=0.48,P=0.511)。单纯放疗组和同步放化疗组不良反应主要以1~2级为主,其中白细胞减少(56.10%∶72.20%)、血小板减少(58.82%∶76.80%)、恶心呕吐(34.04%∶56.90%)发生率的差异均有统计学意义(χ2=11.23,P=0.003;χ2=11.82,P=0.002;χ2=12.77,P=0.000)。结论 同步放化疗治疗宫颈癌的疗效优于单纯放疗,可以提高3年和5年总生存率,但同时也应注意到同步放化疗可能引起的不良反应增加,对于年龄≥60岁的宫颈癌患者同步放化疗并未取得更大的生存获益。

关键词: 宫颈肿瘤, 放射疗法, 同步放化疗

Abstract: Objective To investigate the curative effects and adverse reactions of pure radiotherapy and concurrent chemotherapy and radiotherapy for patients with cervical cancer. MethodsOne hundred and twentyseven patients with cervical cancer who accepted treatment in the Affliated Hospital of Inner Mongolia Medical University from May 2010 to May 2012 were collected. All patients were divided into two groups: pure radiotherapy group (n=65) and concurrent chemotherapy and radiotherapy group (n=62). The curative effects, adverse reactions and survival of two groups were observed. ResultsAll patients were completed treatment. The median followup time was 42 months. The rate of complete response in the pure radiotherapy group was 80.0% (52/65), and the rate in the concurrent chemotherapy and radiotherapy group was 82.26% (51/62), with no significant difference (χ2=1.22, P=0.352). The 1year overall survival rates in the pure radiotherapy group and the concurrent chemotherapy and radiotherapy group were 95.38% and 95.16% respectively, with no significant difference (χ2=0.32,P=0.533), but the 3year overall survival rates were 81.54% and 90.32% respectively, the 5year overall survival rates were 72.31% and 83.87% respectively, with significant differences (χ2=5.09, P=0.015; χ2=3.87, P=0.039). However, for the patients who were ≥ 60 years, the 1year overall survival rates in the two groups were 94.62% and 93.91% respectively, the 3year overall survival rates were 85.02% and 87.25% respectively, the 5year overall survival rates were 70.06% and 73.58% respectively, with no significant differences (χ2=0.06, P=0.753; χ2=1.16, P=0.279; χ2=0.48, P=0.511). The adverse reactions were mainly in grades 12. There were significant differences in the rates of leucopenia (56.10% vs. 72.20%), thrombocytopenia (58.82% vs. 76.80%), nausea and vomiting (34.04% vs. 56.90%) among the two treatment groups (χ2=11.23, P=0.003; χ2=11.82, P=0.002; χ2=12.77, P=0.000). ConclusionThe curative effect of concurrent chemotherapy and radiotherapy is better than that with pure radiotherapy for patients with cervical cancer, which can improve the 3year and 5year overall survival. But at the same time, it should be noted that the rates of adverse reactions may be increased during the same period. For the age of 60 or more patients with cervical cancer, concurrent chemotherapy and radiotherapy does not achieve even greater survival benefit.

Key words: Uterine cervical neoplasms, Radiotherapy, Concurrent chemoradiotherapy