目的：总结我科收治的宫颈癌患者同步放化疗的治疗结果，并分析影响预后的因素。方法：2006年1月1日-2010年12月31日收治的170例Ib1-IVa 宫颈癌患者进入回顾性研究。化疗选用含顺铂的三个方案之一，放疗采用外照射加192Ir高剂量率腔内后装照射，A点总剂量78-90Gy，B点外照射剂量46-56Gy。将患者的临床分期、盆腔及主动脉旁淋巴结情况、肿瘤大小（＞or≤4cm）、肿瘤消退情况、肿瘤标志物作为分析因素，用COX回归对上述分析因素与无进展生存期（progression-free survival，PFS）和总生存期（overall sur-vival，OS）的关系进行单因素和多因素分析。结果：单因素和多因素分析显示影响PFS的因素有：临床分期（P＜0．01），肿瘤大小（P＜0．01），肿瘤消退情况（P＝0．01）和肿瘤标志物（P＝0．01）。影响OS的因素为：临床分期（P＝0．01），肿瘤大小（P＝0．01）与肿瘤消退情况（P＜0．01）。5年生存率Ib1-Ⅱa 期患者为：91．5％，Ⅱb 期患者为：70．8％，Ⅲ期患者为：42．7％，IVa 期患者为：20．5％。结论：同步放化疗治疗不能手术切除的宫颈癌患者，影响预后的主要因素是临床分期、肿瘤大小和肿瘤消退情况。%Objective:To evaluate the outcomes and the prognostic factors for cervical cancer after chemoradi-ation.Methods:A total of 170 patients with stage Ib1 -IVa who were treated in our hospital between January 2006 and December 2010 were reviewed and analyzed.All patients received 3D-CRT radiotherapy with one of three regimens of cisplatin-based chemotherapy concurrently and 192 Ir high-dose rate brachytherapy.The total dose of point A ran-ges 78-90Gy and point B ranges 46-56Gy.Sage,lymph node status,tumor size(>or≤4cm),clinical response and tumor marker were used as analysis factors for COX regression univariate and multivariate analyses .Results:Stage (P<0.01),tumor size (P<0.01),clinical response(P=0.01),and tumor marker(P=0.01)were statisti-cally significant,based on univariate and multivariate analyses of PFS according to these factors.Based on analysis on OS,stage(P=0.01),tumor size(P=0.01),and clinical response(P<0.01)showed a significant outcome.The 5 -year survival rates were 91.5% for stages Ib1 -Ⅱa,70.8% for stage Ⅱb,42.7%for stage Ⅲ,and 20.5%for stage IVa.Conclusion:The main prognostic factors of the patients with unresectable cervical cancer treated with concurrent radiochemotherapy are sage,tumor size and clinical response.
展开▼
