【摘要】 目的:探讨分段加速超分割放疗联合化疗治疗晚期子宫颈癌的临床价值。方法:1998年6月～2001年2月分别采用全盆常规放疗(A组)、全盆分段超分割放疗(B组)以及全盆分段超分割放疗同时联合化疗(C组)治疗ⅡB期以上宫颈鳞癌,对放疗不良反应和治疗效果进行临床比较研究。结果:1)A组全疗程平均58d完成,B组39.1d完成,C组40.1d完成,分段超分割放疗组疗程显著短于常规放疗组,P<0.05;2)5年生存率3组分别为39.28%(11/28)、52.17%(12/23)和62.96%(17/27),局部控制率3组分别为57.14%(16/28)、69.57%(16/23)和77.78%(21/27),均有上升趋势,但差异无统计学意义,P>0.05;3)A、B和C组转移率分别为32.14%(9/28)、30.43%(7/23)和3.70%(1/27),单纯放疗组明显高于放化疗组,P<0.05;4)各种近期放疗反应3组差异无统计学意义;远期放疗反应分别为照射野皮下纤维化[发生率3组分别为75.00%(21/28)、65.22%(15/23)和70.37%(19/27)]、阴道闭锁和狭窄、直肠反应及膀胱反应,差异均无统计学意义,P>0.05。结论:全盆加速超分割放疗联合化疗治疗晚期宫颈癌有提高晚期宫颈鳞癌生存率及局部控制率的趋势,并能降低远处转移发生率,明显缩短总疗程,不增加放疗不良反应。更多还原

【Abstract】 OBJECTIVE:To learn the clinical value of the split-course acceierated hyperfractionated radiotheray(SCAHF)plus chemotherapy in the treatment of advanced cervical cancer.METHORDS:From Jun.1998 to Feb.2001,the patients of local advanced cervical cancer were treated by the whole pelvic convertional fractionated radiaotheray(group A),the whole pelvic SCAHF(group B)and the whole pelvic SCAHF plus chemotherapy(group C)separately.RESULTS:1)The average treatment courses were 58 days in group A,39.1 days in group B,40.1 days in group C,and the coures of group B and group C were signigicantly shorter than that of group A(P<0.05).2)The 5 years survival rates were 39.28%(11/28)in group A,52.17%(12/23)in group B,and 62.96%(17/27)in group C(P>0.05);the local control rates were 57.14%(16/28)in group A,69.57%(16/23)in group B,and 77.78%(21/27)in group C,and there were no significant differences(P>0.05).3)The distant metastases rates were 32.14% in group A,30.43% in group B,and 3.7% in group C,and the significant differences were found between group A,B and group C(P<0.05).4)The acute side reactions in all groups were not significantly different(P>0.05).The first reaction of the chronic toxicity was dermof ibrosis within the external radiation,the second was the atresia of vagina,the third was the rectum and the bladder,and there were no significant differences in the three groups(P>0.05).CONCLUSION:The SCAHF plus chemotherapy tends to improves survival rate and local control rate of advanced cervical cancer.It could shorten the treatment course obviously,decreas the distant metastases rate,but not increase the side reaction.更多还原