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目的探讨同步放化疗和单纯放疗治疗中晚期宫颈癌的疗效及不良反应。方法82例Ⅱ、Ⅲ期宫颈癌患者按入院顺序随机分成同步放化疗组(A组)和单放组(B组)。A组52例(Ⅱ期36例,Ⅲ期16例),B组30例(Ⅱ期18例,Ⅲ期12例),均采用钴60外照射DT46Gy(若盆腔受侵明显的缩野加照DT10~16Gy),然后行腔内后装治疗DT20~26Gy/4~5F/2W,共6~7周。放化组在放疗第1天和4周后同步行化疗:DDP20mg d1~5,5-Fu500mg d1~5。结果单放组的中位生存期31个月,平均31.21个月;同步放化疗组的中位生存期34个月,平均32.33个月,两组生存曲线差异有统计学意义(P<0.05)。同步放化组的不良反应高于单纯放疗组,近期不良反应显著高于单纯放疗组,但均能耐受。结论同步放化疗能提高中晚期宫颈癌患者的中位生存期,提高生存率。
Objective To investigate the efficacy and side effects of concurrent chemoradiotherapy and radiotherapy alone in the treatment of advanced cervical cancer. Methods 82 patients with stage Ⅱ and Ⅲ cervical cancer were randomly divided into concurrent chemoradiotherapy group (group A) and single radiotherapy group (group B) according to the sequence of admission. A group of 52 patients (36 cases of stage Ⅱ, 16 cases of stage Ⅲ), group B 30 cases (18 cases of stage Ⅱ, 12 cases of stage Ⅲ), using cobalt 60 external irradiation DT46Gy DT10 ~ 16Gy), and then treated with intracavitary DT20 ~ 26Gy / 4 ~ 5F / 2W, a total of 6 to 7 weeks. Radiotherapy group in the first day and 4 weeks after radiotherapy concurrent chemotherapy: DDP20mg d1 ~ 5,5-Fu500mg d1 ~ 5. Results The median survival time of the radiotherapy group was 31 months (average 31.21 months). The median survival time of the concurrent chemoradiotherapy group was 34 months (average 32.33 months), with significant difference between the two groups (P <0.05) . Adverse reactions of concurrent radiotherapy group were higher than those of radiotherapy group. The recent adverse reaction was significantly higher than that of radiotherapy alone group, but both were tolerant. Conclusions Simultaneous chemoradiotherapy can improve the median survival time and improve the survival rate of patients with advanced cervical cancer.