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目的观察同期放化疗治疗中晚期宫颈癌的临床疗效和毒副反应。方法将2006年1月至2007年1月在西安交通大学第一附属医院92例中晚期宫颈癌患者随机分成放化组42例(A组)及单纯放疗组50例(B组)。采用10MV-X射线根治性放疗,体外全盆腔大野照射DT50Gy,当外照射剂量达20Gy时,照射野中间4cm挡铅,192Ir高剂量率腔内后装放疗,后装治疗A点总剂量DT48Gy。A组在治疗第2、5周始行同步化疗,采用顺铂(DDP)25mg/m2,第1～3天静脉点滴,5-FU350mg/m2,第1～5天静脉点滴,3周为1周期,共2疗程。B组仅行单纯放疗。结果治疗第5周后观察,A组CR4例,PR32例,总有效率85.7%;B组CR2例,PR28例,总有效率60.0%,两组差异有统计学意义(P<0.01)。治疗结束时,A组CR30例、PR8例,总有效率90.5%;B组CR27例、PR9例,总有效率72.0%,两组差异有统计学意义(P<0.05)。提示治疗过程中A组肿瘤消退速度快于B组。患者放疗结束3个月时,两组的有效率分别是97.6%、80.0%,差异有统计学意义(P<0.01)。A组有较明显的骨髓抑制和消化道反应,但患者经治疗后均可耐受。结论同期放化疗治疗中晚期宫颈癌肿瘤消退速度快,可增强疗效,副反应稍增加,但患者能耐受。
Objective To observe the clinical efficacy and toxicity of concurrent chemoradiotherapy in the treatment of advanced cervical cancer. Methods From January 2006 to January 2007, 92 patients with advanced cervical cancer in the First Affiliated Hospital of Xi’an Jiaotong University were randomly divided into radiotherapy group (n = 42) and radiotherapy group (n = 50) (group B). Radiotherapy with 10MV-X Radiotherapy, whole-pelvic Radiotherapy in vitro DT50Gy, when the external radiation dose of 20Gy, the middle of the radiation field 4cm block lead, 192Ir high dose rate cavity after radiotherapy, after treatment A total dose of DT48Gy. The patients in group A were treated with cisplatin (DDP) 25mg / m2, intravenous drip on day 1 to 3, intravenous drip on day 5 to 5, intravenous drip on day 1 to 5, A total of 2 courses. Group B was only a simple radiotherapy. Results After the 5th week of treatment, CR4 cases and PR32 cases in group A had a total effective rate of 85.7%. CR2 and PR28 cases in group B had a total effective rate of 60.0%. There was a significant difference between the two groups (P <0.01). At the end of treatment, CR30 and PR8 in group A had a total effective rate of 90.5%. CR27 and PR9 in group B had a total effective rate of 72.0%. There was significant difference between the two groups (P <0.05). Prompts the treatment group A tumor regression faster than the B group. Three months after the end of radiotherapy, the effective rates of the two groups were 97.6% and 80.0%, respectively, with significant difference (P <0.01). A group of more obvious bone marrow suppression and gastrointestinal reactions, but patients can be tolerated after treatment. Conclusions Radiotherapy and chemotherapy combined with chemotherapy for advanced cervical cancer can rapidly dissipate the tumor and enhance the curative effect. The side effects are slightly increased, but patients can tolerate it.