【摘要】 【目的】比较早期巨块型宫颈癌腹盆腔深部热疗联合同步放化疗和同步放化疗的疗效和安全性之间的差异。【方法】收集2005年3月16日至2009年5月20日经中山大学附属第五医院治疗的ⅠB2期和巨块型ⅡA期的宫颈癌82例,随机分为腹盆腔热疗加同步放化疗组(42例)和同步放化疗组(40例)。两组放化疗方案一致:盆腔外照射(30Gy/15F)+腔内放疗(A点剂量36Gy/6F),同期静脉TP方案化疗2周期。热放化疗组采用区域深部热疗,2次/周,每次60 min,每次热疗均在放疗前1h内进行。【结果】热放化疗组完全缓解率、5年无复发生存率及5年生存率分别为88.1%、83%及85%,单纯放化疗组分别为70.0%、70%及75%,两组比较均有统计学意义,P值分别为0.043、0.049及0.039;远处转移率热放化疗组(4.7%)与放化疗组(10.0%)比较差异无统计学意义(P=0.397);骨髓抑制、膀胱及胃肠反应等毒副反应2组比较无显著差异(P>0.05)。【结论】与同期放化疗相比,局部热疗联合同步放化疗更能提高宫颈癌完全缓解率,提高5年生存率及无复发生存率,未增加远处转移机会,治疗毒副反应无明显增加,安全有效。更多还原

【Abstract】 【Objective】 To compare the curative effect and safety of abdominal and pelvic deep hyperthermia combined with chemoradiotherapy and chemoradiotherapy in early-stage bulky cervical carcinoma. 【Methods】 82 cases with stage ⅠB2 and bulky ⅡA cervical cancer treated in the Fifth Affiliated Hospital Sun Yat-sen University from March 16, 2005 to May 20, 2009 were randomly divided into two groups, group 1(Hyperthermia group)(42 cases) treated by anterior abdominal pelvic hyperthermia combined with concurrent chemoradiotherapy, group 2(Control group)(40 cases) by concurrent chemoradiotherapy. Two groups were treated with the same scheme of chemoradiotherapy : two cycles of intravenous chemotherapy with TP and concurrent external radiotherapy to the pelvic cavity with a dose of 30 Gy/15 F and intracavitary brachytherapy. The test group was treated with pelvic deep hyperthermia : 2times per week, 60 minutes every time. Each hyperthermia is conducted within 1 hour before radiotherapy. Both groups then underwent regularly follow-up and review after therapy. 【Results】 The complete remission rates in the Hyperthermia group and the control group were 88.1% and 70.0%, respectively(P = 0.043), the relapse-free survival rates for five years were 83% and 70%,respectively(P = 0.049), the five-year survival rates were 85% and 75%, respectively(P = 0.039), there were all significant statistical difference in comparison of two groups. There was no significant statistical difference in distant metastasis rate, 4.7% versus10.0%(P = 0.397); The difference in bone marrow suppression, bladder and gastrointestinal reactions side effects of 2 groups were not statistically significant(P > 0.05). 【Conclusion】Compared with the concurrent chemoradiation, hyperthermia combined with concurrent chemoradiotherapy is more effective in improving complete response rate, can prolong the relapse-free survival and overallsurvival time in patients with early-stage bulky cervical carcinoma. The combination of hyperthermia and concurrent chemoradiotherapy did not increase the treatment related toxicities and the chance of distant metastasis which may be a safe and effective treatment in patients for early-stage bulky cervical carcinoma.更多还原