【摘要】 目的探讨同步放化疗序贯手术治疗局部晚期宫颈癌的安全性及有效性。方法 70例ⅠB2～ⅡB期宫颈癌患者均接受调强放疗及同步奈达铂每周方案化疗,肿瘤明显消退后行根治性子宫切除术+盆腔淋巴结清扫术。记录急性放疗及化疗相关不良反应发生情况,同步放化疗完成后2～3周评价短期疗效,术后随访评估生存情况。结果同步放化疗期间Ⅲ、Ⅳ度白细胞减少的发生率分别为7. 14%、4. 28%,Ⅲ、Ⅳ度血小板降低的发生率均为8. 57%,Ⅲ、Ⅳ度恶心呕吐的发生率分别为8. 57%、2. 86%,Ⅲ、Ⅳ度血红蛋白减少的发生率分别为7. 14%、5. 71%。同步放化疗后,分别有43例(61. 43%)、27例(38. 57%)患者达到完全缓解及部分缓解。1年生存率为100. 0%,2年生存率为89. 0%,3年生存率为73. 0%。结论对于局部晚期宫颈癌患者,调强放疗及同步奈达铂化疗的耐受性良好,联合手术治疗可获得较好的远期疗效。更多还原

【Abstract】 Objective To explore the safety and effectiveness of concurrent chemoradiotherapy followed by sequential surgery for locally advanced cervical cancer. Methods Seventy patients with stage ⅠB2-ⅡB cervical cancer underwent intensity-modulated radiation therapy and weekly concurrent chemotherapy of nedaplatin,then received radical hysterectomy and pelvic lymphadenectomy after obvious tumor regression. The incidences of acute chemoradiotherapy-related adverse reactions were recorded,the short-term efficacy was assessed 2-3 weeks after concurrent chemoradiotherapy,and the survival was evaluated during postoperative follow-up. Results During the concurrent chemoradiotherapy,the incidence rates of grade Ⅲ and Ⅳ leukopenia were 7. 14% and 4. 28%,respectively,the incidence rates of grade Ⅲ and Ⅳ thrombocytopenia were both 8. 57%,the incidence rates of grade Ⅲ and Ⅳnausea/vomiting were 8. 57% and 2. 86%,respectively,and the incidence rates of grade Ⅲ and Ⅳ hypohemoglobinemia were 7. 14% and 5. 71%,respectively. After concurrent chemoradiotherapy,43( 61. 43%) patients and 27( 38. 57%)patients achieved complete remission and partial remission,respectively. The one-year,two-year and three-year survival rates were 100. 0%,89. 0% and 73. 0%,respectively. Conclusion For patients with locally advanced cervical cancer,intensity-modulated radiation therapy and concurrent nedaplatin-contained chemotherapy achieves a good tolerability and a good long-term efficacy when combined with surgery.更多还原