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目的:探讨顺铂加一体化后装腔内放疗在中晚期宫颈癌治疗中的临床应用价值。方法:将126例中晚期宫颈癌患者随机分为顺铂加一体化后装治疗组(A组64例)和一体化后装治疗组(B组62例)。A组于后装治疗的前4~6 h给予顺铂30 mg/m2,静脉滴入,两组后装与体外放疗方案相同,观察两组患者的治疗效果及不良反应。结果:A组和B组的近期有效率均为100%,其中CR率分别为96.88%和95.16%。A组和B组1、2和3年累积生存率分别为100%、97.30%、92.43%和100%、93.89%、74.41%,A组3年累积生存率与B组比较差异有统计学意义,χ2=1.56,P<0.05。A组和B组的局部复发率分别为4.69%和16.13%,差异有统计学意义,P=0.035;远处转移率分别为3.13%和14.52%,两组比较差异有统计学意义,P=0.024。对两组患者的毒副反应进行比较,上消化道反应与白细胞下降A组与B组,差异无统计学意义,P>0.05。结论:顺铂加一体化后装治疗中晚期宫颈癌有较好的临床疗效,可降低局部复发率和远处转移率,提高3年累积生存率,毒副反应可耐受。
Objective: To investigate the clinical value of cisplatin plus integrated post-cavity radiotherapy in the treatment of advanced cervical cancer. Methods: One hundred and sixty-six patients with advanced cervical cancer were randomly divided into cisplatin combined with afterloading treatment group (64 cases in group A) and integrated afterloading treatment group (group B, 62 cases). In group A, cisplatin 30 mg / m2 was given intravenously 4 ~ 6 h before the end of treatment. The two groups were the same as the in vitro radiotherapy program. The therapeutic effects and adverse reactions of the two groups were observed. Results: The recent effective rates in group A and group B were 100%, and the CR rates were 96.88% and 95.16% respectively. The cumulative survival rates at 1, 2, and 3 years in group A and group B were 100%, 97.30%, 92.43% and 100%, 93.89% and 74.41%, respectively. The cumulative 3-year survival rates in group A and group B were significantly different , χ2 = 1.56, P <0.05. The local recurrence rates in group A and group B were 4.69% and 16.13%, respectively, with a significant difference (P = 0.035). The distant metastasis rates were 3.13% and 14.52% respectively. There was significant difference between the two groups (P = 0.024. Toxic side effects of the two groups of patients were compared, upper gastrointestinal reaction and leukopenia group A and group B, the difference was not statistically significant, P> 0.05. Conclusion: Cisplatin combined with integrated post-treatment of advanced cervical cancer have better clinical efficacy, can reduce the local recurrence rate and distant metastasis rate, increase 3-year cumulative survival rate, toxicity can be tolerated.