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目的:探讨Ⅱ B期宫颈鳞癌不同治疗方案的远期生存情况。方法:回顾性分析2010年1月至2013年12月Ⅱ B期宫颈鳞癌患者共106例,将其分为3组:同步放化疗组(CCRT组)36例,根治性手术组(RS组)31例,新辅助化疗+根治性手术组(NACT+RS组)39例,观察各组的预后情况。结果 :本研究平均随访时间为28个月,Cox多因素分析结果显示治疗方式为影响总生存率的独立危险因素,CCRT组、NACT+RS组、RS组3年总体生存率(OS)分别是96.7%、92.4%和65.9%,3组间有统计学差异(P<0.001),3年无病进展生存率(DFS)分别是89.7%、89.3%和97.2%,但3组间无统计学差异(P=0.323)。结论:对于Ⅱ B期宫颈鳞癌患者:(1)同步放化疗治疗可提高患者的生存率;(2)手术治疗虽不能提高患者生存率但可能会降低患者的复发率;(3)新辅助化疗+手术治疗不能提高患者的生存率,因此在实际应用过程中需要根据患者的实际情况予以考虑。
Objective: To investigate the long-term survival of different treatment options for stage Ⅱ B cervical squamous cell carcinoma. Methods: A total of 106 patients with stage Ⅱ B cervical squamous cell carcinoma from January 2010 to December 2013 were retrospectively analyzed. The patients were divided into three groups: 36 cases in CCRT group and 2 cases in radical operation group (RS group) ) 31 cases, neoadjuvant chemotherapy + radical operation group (NACT + RS group) 39 cases, the prognosis of each group was observed. Results: The average follow-up time of this study was 28 months. Cox multivariate analysis showed that the treatment was an independent risk factor for overall survival. The 3-year overall survival rates (OS) of CCRT, NACT + RS and RS groups were 96.7%, 92.4% and 65.9%, respectively. There was a significant difference between the three groups (P <0.001). The 3-year progression-free survival rates were 89.7%, 89.3% and 97.2% Difference (P = 0.323). Conclusions: Patients with stage Ⅱ B cervical squamous cell carcinoma: (1) concurrent chemoradiotherapy can improve the survival rate of patients; (2) although surgical treatment can not improve the survival rate of patients but may reduce the recurrence rate of patients; (3) neoadjuvant Chemotherapy + surgical treatment can not improve the survival rate of patients, so in the actual application process needs to be based on the actual situation of patients to be considered.