目的 讨论多种医疗方式治疗初期子宫内膜癌的疗效及预后.方法 回顾性分析我院早期子宫内膜癌患者185例临床资料,将其分为单纯手术组(n=28)、单纯放疗组(n=37)、术后放疗组(n=50)、术前全量放疗组(n=35)、术前腔内后装组(n=35),比较各组5年生存率、局部复发率、远处转移率和放疗并发症等指标.结果 单纯放疗组和术前腔内后装组的5年生存率差异有统计学意义(P ＜ 0.05);单纯手术组和单纯放疗组与其他三组间的局部复发率差异均有统计学意义(P ＜ 0.05);各组之间的远处转移率差异无统计学意义(P > 0.05);术前腔内后装组放射性肠炎的发生率与其他各组放射性肠炎的发生率差异有统计学意义(P＜0.05).结论 治疗早期子宫内膜癌的技术是主要以手术为主的综合治疗,术前全量放疗差于术前腔内后装放疗.术前、术后放疗均能有效地降低患者的局部复发率,但并不能改善远处转移.%The clinical datas of 185 oases of patients with early endomelrial cancer in our hospital were analyzed retrospectively. All patients were divided into simple operation group (n-28), simple radiotherapy group (re=37), postoperative radiotherapy group (n~50), preoperative whole airiount radiotherapy group (n~35) and the intracavitary afterloading group (n=35j. The five years survival rate, local recurrence rate, distant metastasis rate, complications of radiotherapy and other indicators of each group were compared. Results The survival rate was compared between the simple radiotherapy group and the preoperative intracavitary afterloading group, the difference was significant (P < 0.05). The local recurrence rates were compared among simple operation group, simple radiotherapy group and the other three groups, the differences were both significant (P < 0.05). The distant metastasis rates were not significant differences among each groups (P > 0.05). The incidence of radiation enteritis of the preoperative intracavitary afterloading group were different from other groups significantly [P < 0.05). Conclusion The main therapy for early endometrial cancer is the operation-oriented comprehensive therapy. Preoperative whole amount radiotherapy is inferior to preoperative Intracavitary afterloading radiotherapy. Preoperative and postoperative radiotherapy can both effectively reduce the local recurrence rate of patients, but can not Improve the distant metastasis.
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