宫颈癌合并大出血的临床特征及放疗疗效观察

摘要

Objective To investigate the clinical features and radiotherapy curative effects for cervical cancer with massive hemorrhage.Methods The major clinical data of 19 massive bleeding patients with cervical cancer treated with irradiation from January 2002 toDecember 2012 were retrospectively analyzed.Clinical characteristics were studied and local control and survival rates were analyzed.The median age of the entire cohort was 44.5 years.There were 14 cases (73.6%)of FIGO stages IIIB,13 cases (68.4%)of vaginalinvaded,18 cases (94.7%)of patients with tumor diameter >4 cm.Results Complete response (CR)rate,partial response (PR)rate and total effective rate (CR +PR)were 26.3% (5 /19),68.4% (13 /19),and 94.7%,respectively.The 1-year,2-year and 3-year overall survival rates were 72.2%,46.4% and 38.7% respectively.The median overall survival was 18 months.Conclusions Younger,advanced clinical staging,obviously vaginal and parametrial involvement,large tumor size,bad prognosis are main clinical fea-tures for cervical cancer with massive bleeding.Uterine artery chemoembolization,blood transfusion,EPO and other factors will comprisethe curative effect of radical radiotherapy for cervical cancer.%目的：探讨宫颈癌合并大出血患者的临床特征及放疗疗效。方法回顾分析2002年1月到2012年12月合并大出血的宫颈癌患者行根治性放射治疗19例患者的临床资料，分析其临床特征及局部控制率、生存率。患者平均年龄为44．5岁，Ⅲb期14例（73．6％），阴道受侵13例（68．4％），肿瘤直径＞4 cm者18例（94．7％）。结果放疗后近期疗效达CR者5例（26．3％）、PR者13例（68．4％）、总有效率（CR＋PR）为94．7％。1、2、3年生存率分别为72．2％、46．4％和38．7％，中位生存期18月。结论年轻、分期晚、合并阴道宫旁受侵明显，大肿块、预后差是宫颈癌合并大出血患者主要临床特征。子宫动脉化疗栓塞术、输血、EPO等治疗对宫颈癌合并大出血患者根治性放疗疗效均有不同影响。