【摘要】 目的研究宫颈癌Ⅱb期患者的治疗方式。方法收集1998年5月-2000年6月Ⅱb期宫颈癌88例,根据采用的不同治疗方法分为三组。A组318例,给予根治性放疗辅以3-6周期化疗;B组50例,术前局部放疗或辅以介入化疗,后行宫颈癌根治术,其中术后高危(间质深层浸润、脉管癌栓、宫旁浸润、盆腔淋巴结转移及残留癌)的20例病人(C组)辅以盆腔照射或化疗。结果A组、B组、C组的五年生存率分别为71.1%、76.0%、40.0%,A、B两组的五年生存率无显著性差异(P>0.05),A、C两组的五年生存率有显著性差异(P<0.05)。A组13.2%有放射性直肠炎,5.3%有放射性膀胱炎,无直肠及膀胱阴道瘘;B组6%有术中血管、神经损伤,80%有术后淋巴囊肿,4%下肢浮肿,16%膀胱功能障碍,4%感染,术后放疗25%发生放射性肠炎。结论手术结合术前放疗及化疗治疗宫颈癌Ⅱb期患者的生存率与放化疗综合治疗相似,而手术的并发症多,术后放疗剂量不能增加,术后高危组生存率低,故Ⅱb期宫颈癌应严格掌握手术指征,宜采取放射治疗辅以化疗的综合治疗方法。更多还原

【Abstract】 Objective To study the therapy ways of cervical cancer in stage Ⅱb. Methods Eighty-eight cases with cervical carcinoma in stage Ⅱb from May 1998 to June 2000 collected in the series were divided into three groups according to different treatment means. Thirty-eight cases of radiotherapy combinated chemotherapy were put into group A, 50 cases undergoing surgical operation after local radiotherapy, or combination of radiotherapy and chemotherapy were put into group B, and 20 cases among the 50 patients with high-risk factors (pelvic lymph node metastasis, parametric extension, vaginal margin involved and deep stroma invasion, and lymphatic permeation) were put into group C. Results The 5-year survival rate of group A, group B and group C was 71. 1% , 76. 0% and 40. 0%, respectively. The 5-year survival rate of group A had unconspicuous difference with group B (P>0. 05), but had conspicuous difference with group C (P<0. 05) . Among 50 cases of group A, there were 13. 2% with radiation rectitis, 5. 3% radiation cystitis, and no case rectovaginal and vesicovaginal fistulae. Among 38 cases of group B, there were 6% with blood-vessel and nerve injure, 80% lymphocyte cyst, 4% lower limb dropsy, 16% bladder function handicap, 4% infection, and 25% radiation rectitis. Conclusion It is suggested that combining radiotherapy with chemotherapy is the best therapeutic way for the patients with cervical cancer in stage Ⅱb.更多还原