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目的:探讨中晚期宫颈鳞状细胞癌锎252中子同期放化疗与单纯放疗的近期疗效、并发症及生存率的差异。方法:回顾分析2008年~2009年间收住我院的宫颈鳞状细胞癌,临床分期ⅡB-ⅢB期患者80例。其中42例接受了外照射加锎252中子后装治疗为单纯放疗组;38例放疗同时接受每周一次顺铂同步化疗为同步放化疗组。比较两组患者的近期疗效、毒副作用及生存率之间的差异。结果:同步放化疗组近期有效率(CR+PR)为92.10%(35/38),显著高于单纯放疗组的71.42%(30/42)(P<0.05);同步放化疗组的3年和5年生存率分别为92.1%、84.2%,高于单纯放疗组90.47%、71.4%;同步放化疗组的毒副反应和放射性损伤等不良反应显著高于单纯放疗组(P<0.05),但经治疗后均能耐受。结论:对中晚期宫颈鳞癌患者,同步放化疗法比单纯放疗具有较好的近期疗效;骨髓抑制副作用的发生率高于后者,而放射性肠炎和膀胱炎的发生率无差异;二者生存曲线无显著差异。
Objective: To investigate the short-term curative effect, complications and survival rate of advanced cervical squamous cell carcinoma 锎 252 neutron chemoradiotherapy with radiotherapy alone. Methods: A retrospective analysis of cervical squamous cell carcinoma admitted to our hospital from 2008 to 2009, clinical stage Ⅱ B-Ⅲ B of 80 patients. Among them, 42 cases received external irradiation plus 锎 252 neutron afterloading therapy as a single radiotherapy group; 38 cases of radiotherapy while receiving cisplatin concurrent chemotherapy once a week as a concurrent chemoradiation group. The short-term efficacy, side effects and survival rates were compared between the two groups. Results: The response rate (CR + PR) of concurrent chemoradiotherapy group was 92.10% (35/38), significantly higher than 71.42% (30/42) in radiotherapy alone group (P <0.05) And 5-year survival rates were 92.1% and 84.2%, respectively, higher than 90.47% and 71.4% in radiotherapy alone group. Adverse reactions and radioactive injury in concurrent radiotherapy and chemotherapy group were significantly higher than those in radiotherapy alone group (P <0.05) But after treatment can tolerate. Conclusions: For advanced cervical squamous cell carcinoma, concurrent chemoradiotherapy has a better short-term curative effect than radiotherapy alone. The incidence of bone marrow suppression is higher than that of the latter, while there is no difference in the incidence of radiation enteritis and cystitis. No significant difference in the curve.