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目的:对比手术为主的综合治疗及同步放化疗治疗ⅡB期宫颈癌的疗效和并发症。方法:选择2001年1月至2008年4月收治的ⅡB期宫颈鳞癌患者147例,分为以手术为主的综合治疗组(72例,术前予紫杉醇为主的化疗,根治性手术后或需补充放疗)和同步放化疗组(75例,予顺铂为主的化疗,同步给予放疗),对两组患者的疗效及并发症发生情况进行对比分析。结果:手术组化疗有效率为73.6%,同步放化疗组有效率为70.6%,其5年生存率分别为81.9%和78.6%,手术组的并发症主要为血液毒性术后尿潴留和淋巴囊肿的发生,经对症处理短时间内痊愈。同步放化疗组的并发症主要为骨髓抑制和放射性直肠炎、膀胱炎、阴道挛缩,前者可痊愈,后者严重者甚至穿孔。结论:手术为主的综合治疗ⅡB期宫颈癌可明显提高患者有效率、5年生存率及生活质量。
OBJECTIVE: To compare the curative effect and complication of surgery-based comprehensive treatment and concurrent chemoradiotherapy for stage IIB cervical cancer. Methods: A total of 147 patients with stage ⅡB cervical squamous cell carcinoma who were admitted to our hospital from January 2001 to April 2008 were selected and divided into two groups: surgery-based comprehensive treatment group (72 cases, preoperative paclitaxel-based chemotherapy, radical surgery Or need to add radiotherapy) and concurrent radiotherapy and chemotherapy group (75 cases, cisplatin-based chemotherapy, simultaneous radiotherapy), the efficacy and complications of the two groups of patients were compared. Results: The effective rate was 73.6% in the operation group and 70.6% in the concurrent chemoradiation group. The 5-year survival rates were 81.9% and 78.6% respectively. The complication of the operation group was mainly hematuria postoperative urinary retention and lymphatic cyst The occurrence of symptomatic treatment by a short period of recovery. The main complications of concurrent chemoradiotherapy group were myelosuppression and radiation proctitis, cystitis and vaginal contracture, the former could be cured, while the latter was severe or even perforated. Conclusions: Surgical-based comprehensive treatment of stage IIB cervical cancer can significantly improve the patient’s efficiency, 5-year survival rate and quality of life.