目的评价同步放化疗治疗局部晚期宫颈癌的效果及安全性。方法选择Ⅰb2、Ⅱa2期宫颈癌患者120例纳入研究对象,随机均分成三组。A组直接行同步放化疗,B组先行广泛全子宫切除术加盆腔淋巴结清除术,术后再行同步放化疗,C组仅行根治性放疗。比较各组的治疗效果和不良反应发生情况。结果 A组3年生存率高于B、C组(95.0%vs.85.0%、82.5%),局部复发及远处转移率低于B、C组(P均<0.05)。A组Ⅲ度以上骨髓抑制、胃肠道反应、肝肾功能损害发生率高于C组,A组急性直肠毒性、急性膀胱毒性发生率低于B组(P均<0.05)。结论直接同步放化疗治疗局部晚期宫颈癌效果优于手术后同步放化疗和单纯放疗,且安全性良好。 Objective To evaluate the efficacy and safety of concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer. Methods A total of 120 patients with stage Ⅰb2 and Ⅱa2 cervical cancer were enrolled in the study and randomly divided into three groups. Group A received concurrent chemoradiotherapy directly. Group B received extensive hysterectomy plus pelvic lymphadenectomy, followed by concurrent chemoradiotherapy after operation. Group C received only radical radiotherapy. Compare the treatment effect of each group and the occurrence of adverse reactions. Results The 3-year survival rate of group A was significantly higher than that of group B and C (95.0% vs 85.0%, 82.5%). The recurrence and distant metastasis rates were lower in group A than in groups B and C (all P <0.05). Group A had more than grade Ⅲ myelosuppression, gastrointestinal reaction and liver and renal dysfunction. The incidence of acute reteotoxicity and acute cystotoxicity in group A was lower than that in group B (all P <0.05). Conclusions The direct concurrent chemoradiotherapy is superior to concurrent chemoradiotherapy and radiotherapy alone in the treatment of locally advanced cervical cancer and is safe.