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目的:探讨同步放化疗相对于单纯放疗或单纯化疗的非手术疗法治疗中晚期宫颈癌的有效性。方法:收集2005-2012年本院妇科和放化疗科诊治的中晚期宫颈癌病人,从中选取符合治疗条件的病人分为三组:(1)单纯放疗组30例;(2)单纯化疗组20例;(3)放化疗联合治疗组80例。对这130例病人的临床资料进行对比分析。结果:单纯放疗组低分化者肿瘤缩小率(55.7%)显著高于高中分化者(35.4%),单纯化疗组高中分化者肿瘤缩小率(61.1%)显著高于低分化者(42.3%),同步放化疗组分化程度与肿瘤缩小率无统计学差异;同步放化疗组肿瘤平均缩小率(72.6%)显著高于单纯放疗组(37.7%)和单纯化疗组(44.6%)(P<0.05)。宫旁转移率三者比较差异无统计学意义。结论:同步放化疗可使肿瘤体积在明显缩小,并能降低淋巴结转移率,延长生存期。低分化宫颈癌对放疗敏感,高中分化宫颈癌对化疗敏感。晚期浸润性宫颈癌治疗中同步放化疗较单纯放化疗更有效。
Objective: To investigate the efficacy of concurrent chemoradiotherapy versus non-surgical treatment of advanced cervical cancer compared with simple radiotherapy or chemotherapy alone. Methods: The patients with advanced cervical cancer treated by gynecology and radiotherapy and chemotherapy from 2005 to 2012 were collected and divided into three groups according to the treatment conditions: (1) 30 cases of radiotherapy alone; (2) 20 cases of chemotherapy alone Cases; (3) radiotherapy and chemotherapy combined treatment group of 80 cases. The clinical data of 130 patients were compared. Results: The tumor shrinkage rate (55.7%) in poorly differentiated radiotherapy group was significantly higher than that in high differentiated (35.4%) patients. The rate of tumor shrinkage was significantly higher in poorly differentiated radiotherapy group (61.1% vs 42.3% There was no significant difference in the degree of tumor differentiation between the concurrent chemoradiation group and the chemotherapy group (72.6% vs. 37.7%, 44.6%, P <0.05) . There was no significant difference in the rate of uterine metastasis between the three groups. Conclusions: Concurrent chemoradiotherapy can significantly reduce tumor volume, reduce lymph node metastasis and prolong survival. Poorly differentiated cervical cancer sensitive to radiotherapy, high school differentiation of cervical cancer sensitive to chemotherapy. Concurrent chemoradiation is more effective than radiotherapy alone in the treatment of advanced invasive cervical cancer.