同步放化疗单纯放疗与序贯放化疗治疗中晚期宫颈癌的临床疗效研究

摘要

Objective Through a retrospective analysis of clinical data of 9 3 cases with advanced cervical cancer ,received radiotherapy ,concurrent chemo -radiotherapy and sequential chemo -radiotherapy ,in order to obtain the clinical efficacy and adverse reactions of the three treatments ,to provide relevant informations to the individual treatment of advanced cervical cancer .Methods We collected 9 3 patients with advanced cervical (Ⅱb- Ⅲb) from march 2 0 0 8 to march 2 0 1 2 .Concurrent chemo -radiotherapy group is 3 4 cases ,Sequential chemo -radiotherapy group is 3 0 cases ,Radiotherapy group is 2 9 cases .Results The total effective rate of 8 0 .6% .The efficiency of radiotherapy group is 6 2 .1% ,the efficiency of concurrent chemo -radiotherapy group is 9 1 .2% and efficiency of sequential chemotherapy group is 8 6 .7% .Short term efficacy :The efficiency of concurrent chemo -radiotherapy versus sequential chemo -radiotherapy was superior to radiotherapy group ,P<0 .0 5 ,and the effi-ciency of concurrent chemo -radiotherapy versus sequential chemo -radiotherapy group was no significant differ-ence( P>0 .0 5 ) .Toxicity of three groups were different ( P<0 .0 5 ) ,concurrent chemo -radiotherapy more obvi-ous poisoning side effects in the three groups ( P<0 .0 5 ) ,radiotherapy group and sequential chemo -radiotherapy group of adverse reaction of no statistical significance (P>0 .05 ) .The gastrointestinal reactions :the radiothera-py group ,concurrent chemo -radiotherapy group and sequential group 2 7 .6% ,6 1 .8% ,3 6 .7% .Marrow sup-pression mainly caused leukocyte decline were 2 7 .6% ,6 7 .6% ,4 0% .Bladder reaction 1 3 .8% ,5 2 .9% ,2 6 .7% . Three years survival rate of three groups :Concurrent chemo -radiotherapy group in 8 0% ,Sequential chemo -radiotherapy group and radiotherapy alone basic same about 7 0% .Conclusion Concurrent chemo -radiotherapy are the best advantageous and efficacious in the three group .%目的：回顾性分析中晚期宫颈癌患者接受单纯放疗、同步放化疗以及序贯放化疗3种不同治疗方式的临床资料，以期获得3种治疗方式的临床疗效及不良反应，为中晚期宫颈癌个体化治疗提供相关依据。方法收集2008年3月至2012年3月93例均经病理学证实为（Ⅱb～Ⅲb）中晚期宫颈的患者，同步放化疗组34例、序贯放化疗组30例、单纯放疗组29例。结果3组总有效率为80．6％，其中单纯放疗组有效率62．1％，同步放化疗组有效率91．2％，序贯放化疗组86．7％。3组近期疗效比较：同步放化疗组与序贯放化疗组近期疗效优于单纯放疗组（P＜0．05），同步放化疗组与序贯放化疗组无显著差异（P＞0．05）。毒副反应：同步放化疗组在3组中毒副反应较为明显（P＜0．05），单纯放疗组与序贯放化疗组的毒副反应无统计学意义（P＞0．05）。单纯放疗组、同步放化疗组、序贯放化疗组消化道反应分别为27．6％、61．8％和36.7％；骨髓抑制主要引起白细胞下降，分别为27．6％、67．6％和40％；膀胱反应分别为13．8％、52．9％和26.7％。3年生存率，同步放化疗组3年生存率80％，序贯放化疗组和单纯放疗组约70％。结论3组方案中同步放化疗在治疗中晚期宫颈癌方面具有一定的优势和疗效。