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目的初步评价根治性同步放化疗+手术治疗局部晚期宫颈癌的疗效。方法将102例局部晚期宫颈癌患者随机分为试验组和对照组。对照组单纯采用根治性同步放化疗,化疗方案为单药顺铂35~40 mg/m~2,每周1次。试验组在对照组基础上,联合广泛性全子宫切除术及盆腔淋巴结清扫术,宫旁组织和阴道组织各切除3 cm。结果试验组纳入52例患者,对照组纳入50例。试验组术后病理资料显示无癌残留率为82.7%,癌残留率为5.8%。试验组无进展生存时间为3~40月,中位生存时间为23月,3年生存率为73.1%;对照组无进展生存时间为5~41月,中位生存时间为22月,3年生存率为64.8%;两组差异无统计学意义(χ~2=0.092,P=0.761)。试验组总生存时间为6~40月,中位总生存时间为23月,3年生存率为82.7%;对照组总生存时间为5~41月,中位生存时间为22.5月,3年生存率为81.8%;两组差异也没有统计学意义(χ~2=0.338,P=0.561)。结论局部晚期宫颈癌采用根治性同步放化疗+手术治疗不能显著提高无进展生存率和总生存率,目前对局部晚期宫颈癌患者的治疗需更谨慎并结合患者病情考虑是否使用该治疗方法。
Objective To evaluate the curative effect of radical concurrent chemoradiotherapy and surgical treatment of locally advanced cervical cancer. Methods 102 patients with locally advanced cervical cancer were randomly divided into experimental group and control group. The control group was treated with radical concurrent chemoradiotherapy. The chemotherapy regimen consisted of monotherapy with cisplatin 35-40 mg / m ~ 2 once a week. The experimental group in the control group, combined with extensive hysterectomy and pelvic lymph node dissection, uterine tissue and vaginal tissue resection of 3 cm. Results The trial group included 52 patients and the control group included 50 patients. Postoperative pathological data of the experimental group showed no residual cancer rate was 82.7%, cancer residual rate was 5.8%. The progression-free survival time was 3 to 40 months in the experimental group, the median survival time was 23 months, and the 3-year survival rate was 73.1%. The progression-free survival time in the control group was 5 to 41 months, and the median survival time was 22 months and 3 years The survival rate was 64.8%. There was no significant difference between the two groups (χ ~ 2 = 0.092, P = 0.761). The overall survival time was 6 to 40 months in the experimental group, the median overall survival time was 23 months, the 3-year survival rate was 82.7%; the control group, the total survival time was 5 to 41 months, the median survival time was 22.5 months, 3-year survival The rate was 81.8%. There was also no significant difference between the two groups (χ ~ 2 = 0.338, P = 0.561). Conclusions Radical concurrent chemoradiotherapy + surgical treatment of locally advanced cervical cancer can not significantly improve the progression-free survival rate and overall survival rate. Currently, the treatment of patients with locally advanced cervical cancer needs to be more cautious and consider whether to use the treatment according to the patient’s condition.