单纯放疗与顺铂联合氟尿嘧啶同步放化疗治疗中晚期宫颈癌患者的临床效果比较

摘要

目的:比较单纯放疗与顺铂联合氟尿嘧啶同步放化疗治疗中晚期官颈癌患者的临床效果.方法:选择2012年3月～2014年3月在我院进行诊治的中晚期宫颈癌患者87例,按住院序号分为观察组43例和对照组44例.对照组给予单纯放疗,观察组在常规放疗的的间歇给予同步化疗,静脉滴注600mg/m2的5-氟尿嘧啶以及50 mg/m2的顺铂,每周一次,共治疗6个周期.每次化疗结束后半小时内开展体外放疗.比较两组的临床治疗效果,血小板减少、白细胞下降、肾功能受损以及恶心呕吐等毒副反应的发生情况.对两组患者进行3年的随访,观察两组的复发率、转移率以及3年生存率.结果:治疗后,观察组的近期有效率为90.63％(39/43),明显高于对照组的79.04％(32/44)(P＜0.05).经过3年的随访,观察组的复发率以及转移率均明显低于对照组(P＜0.05),3年生存率明显高于对照组(P＜0.05),血小板减少、白细胞下降、肾功能受损以及恶心呕吐等毒副反应的发生率明显高于对照组(P＜0.05).结论:顺铂联合氟尿嘧啶同步放化疗治疗中晚期宫颈癌患者的近期疗效以及远期疗效明显优于单纯放疗,毒副反应发生率较高,但在可控制的范围内.%Objective:To compare the effects of simple radiotherapy and cisplatin combined with fluorouracil in the concurrent chemoradiotherapy for patients with advanced cervical cancer.Methods:87 cases of patients with advanced cervical cancer who were treated in our hospital from March 2012 to March 2014were selected and randomly divided into the control group which was treated with simple radiotherapy and the observation group which was treated with concurrent chemoradiotherapy,with intravenous infusion of 600 mg/m2 of 5-fluorouracil,and 50 mg/m2 of cisplatin once a week,for a total of 6 cycles.The extracorporeal radiotherapy was performed within half an hour after each chemotherapy ended.The clinical effects,incidence of adverse reactions such as thrombocytopenia,decreased WBC,impaired renal function and nausea and vomiting were compared between the two groups.Both groups of patients were followed up for 3 years,the recurrence rate,metastasis rate and long-term survival rate were observed and compared between the two groups.Results:After treatment,the effective rate of observation group was 90.63％(39/43),which was significantly higher than that of the control group79.04％(32/44)(P＜0.05);after 3 years of follow-up,the recurrence rate and metastasis rate of the observation group were significantly lower than those of the control group (P＜0.05),the 3 year survival rate of observation group was significantly higher than that of the control group (P＜0.05);the incidence of adverse reactions such as thrombocytopenia,decreased WBC,impaired renal function and nausea and vomiting in the observation group was significantly higher than that of the control group (P＜0.05).Conclusions:The short-term efficacy and long-term effect of cisplatin and fluorouracil concurrent chemoradiotherapy is significantly better than that of radiotherapy alone in the treatment of patients with advanced cervical cancer,the incidence of side effects is high,but within the controlled range.