论文部分内容阅读
目的观察宫颈癌术后不同因素对放疗远期疗效的影响。方法1998年收治的各期宫颈癌共525例,其中346例手术治疗,术后放疗者302例。302例分布在Ⅰ、Ⅱa、Ⅱb、Ⅲa期,分别为142、121、23、16例。术后放疗采用60Coγ线或6MVX线前后野垂直交替照射44~50Gy4~5周。根据存在的因素情况酌情扩大射野、缩野加照或阴道后装治疗及少数给予辅助化疗。结果Ⅰ、Ⅱa、Ⅱb、Ⅲa期5年生存率分别为89.4%、77.7%、56.5%、56.2%(χ2=22.22,P<0.01)。浸润浅层、深肌层、全层的5年生存率分别为94.8%、83.1%、62.7%(χ2=27.46,P<0.01)。盆腔内淋巴结转移、脉管瘤栓、残端及宫旁切缘呈阳性的有与无者5年生存率分别为52.3%与88.2%(χ2=41.79,P<0.01)。结论对术后有多种影响因素的患者,术后放疗是必要的,它可减少盆腔复发率。凡认为手术是宫颈癌主要治疗手段,有术后放化疗就可放宽手术适应证是不可取的。
Objective To observe the effect of different factors of postoperative cervical cancer on long-term efficacy of radiotherapy. Methods A total of 525 cases of cervical cancer were admitted in 1998, of which 346 cases were treated by surgery and 302 cases received postoperative radiotherapy. 302 cases distributed in Ⅰ, Ⅱ a, Ⅱ b, Ⅲ a period, respectively, 142,121,23,16 cases. Postoperative radiotherapy with 60Coγ line or 6MVX line before and after the vertical alternating radiation 44 ~ 50Gy4 ~ 5 weeks. According to the existence of factors, as appropriate, expand the scope of the field, shrinkage plus or vaginal afterloading treatment and a small number of adjuvant chemotherapy. Results The 5-year survival rates of Ⅰ, Ⅱa, Ⅱb and Ⅲa were 89.4%, 77.7%, 56.5% and 56.2% respectively (χ2 = 22.22, P <0.01). The 5-year survival rates of the infiltrating superficial, deep myometrium and full-thickness were 94.8%, 83.1% and 62.7%, respectively (χ2 = 27.46, P <0.01). The 5-year survival rates of pelvic lymphatic metastasis, aneurysm thrombus, stump and palatal margin were 52.3% and 88.2%, respectively (χ2 = 41.79, P <0.01). Conclusion For postoperative patients with many influencing factors, postoperative radiotherapy is necessary, which can reduce the pelvic recurrence rate. Where that surgery is the main treatment of cervical cancer, postoperative radiotherapy and chemotherapy can relax the indications of surgery is not desirable.