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目的研究宫颈癌治疗不当和治疗失败的原因。方法2001年5月至2004年3月对辽宁省肿瘤医院收治的外院治疗后近期复发的40例宫颈癌进行分析。结果40例的病理类型为:鳞癌32例,腺癌5例,宫颈上皮内瘤变(CIN)3例。其中23例入我院前已作过手术:3例CIN分别作了全子宫切除(2例),子宫次广泛切除(1例);另外术后的20例中ⅠB～ⅡA期5例,ⅡB～ⅢB期5例,分期不详10例;17例入我院前接受过体外放疗,放射剂量为<40Gy1例,40～60Gy8例,>60Gy8例。40例中29例(70%)需再次治疗发生在6个月内,11例发生在6～12个月内。入院后以放疗治疗术后复发,以化疗治疗放疗后复发,近期临床控制率为35%(14/40)。结论分期不准,治疗方案不恰当,没有按宫颈癌治疗规范治疗是治疗失败的主要原因。
Objective To study the causes of improper treatment and failure of cervical cancer. Methods From May 2001 to March 2004, 40 cases of cervical cancer, which recurred recently after treatment in the Tumor Hospital of Liaoning Province, were analyzed. Results The pathological types of 40 cases were as follows: squamous cell carcinoma in 32 cases, adenocarcinoma in 5 cases, cervical intraepithelial neoplasia (CIN) in 3 cases. Among them, 23 cases had undergone surgery in our hospital. Three cases of CIN were treated with total hysterectomy (2 cases) and extensive hysterectomy (1 case). In addition, 20 cases were treated with ⅠB-ⅡA in 5 cases and ⅡB ~ ⅢB stage 5 cases, stage is unknown in 10 cases; 17 cases were admitted to our hospital before receiving external beam radiotherapy, radiation dose was 40Gy1 cases, 40 ~ 60Gy8 cases,> 60Gy8 cases. Of the 40 patients, 29 (70%) required re-treatment within 6 months and 11 occurred within 6 to 12 months. After admission to radiotherapy and treatment of recurrence, chemotherapy recurrence after radiotherapy, the recent clinical control rate was 35% (14/40). Conclusions Staging is not allowed, the treatment program is not appropriate, not according to the treatment of cervical cancer treatment is the main reason for treatment failure.