同步放化疗治疗中晚期宫颈癌.doc

同步放化疗治疗中晚期宫颈癌

作者：刘少兵，周祖金，陈森，覃瑞萍

【摘要】 目的 观察化疗联合放疗治疗中晚期宫颈癌的临床疗效

和毒副作用。方法 58 例中晚期宫颈癌患者随机分成化放组（29 例）

及单纯放疗组（29 例） ，化放组采用顺铂 25mg/m2 d1 3，静脉点滴，

5 Fu 350mg/m2 d1 5 静脉点滴，每 4 周重复，共 3 个周期，同时

进行根治性放疗，化疗第 1 天开始进行放射治疗。用 10MVX 线体外全

盆照射 DT38～40Gy，中间铅挡后照射致宫旁剂量 DT50～55Gy，第 3

周开始行 192Ir 腔内照射， 次/天/周， 点剂量 6Gy， 点剂量 5Gy，
6Gy/ A B

共 6～7 次。 单纯放射治疗组仅行单纯放疗， 方法同化放组， 不行化疗。

结果 于放疗结束时两组有效率分别为 96.6%及 86.2%，差异无显著(P

＞0.05)。放疗后 3 个月时两组的有效率分别为 96.6%及 65.5%，差异

显著(P＜0.05)。放化组 3、5 年生存率和无瘤生存率分别为 79.3%、

68.9%、62.1%，高于单放组的 62.1%、51.7%、41.4%，差异显著(P＜

0.05)， 随访 5 年， 化放组的盆腔复发率为 17.2%， 低于单放组的 31.0%，

P＜0.05。化放组有较明显的骨髓抑制和消化道反应，但患者经治疗后

均可耐受。结论 化疗联合放疗治疗中晚期宫颈癌可增强疗效，副作用

稍增加，但患者能耐受。

【关键词】 宫颈癌；同步放化疗；疗效；副作用

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Prospective Trial for Concurrent Chemoradiotherapy

Treatment in Medium term and Advanced Cervical Carcinoma

Abstract ： Objective To investigate the clinical

curative effects and side effects of chemoradiotherapy for

medium term and advanced cervical carcinoma. Methods Fifty

eight patients of medium term and advanced cervical

carcinoma were randomly divided into two groups:

chemoradiotherapy groups and only radiotherapy group. Each

patients of the chemoradiotherapy group was given cisplatin at

the dose of 25 mg/m2 ivgtt d1 3 ,5 Fluorouracil,350mg/m2

ivgtt,d1 5, repeat every 28 days, total 3 cycles. And

radiotherapy was give at the same time, 10 MVX ray was used for

external radiation with a total dose of 38～40 Gy； then the middle

field is shielded by plumbum, continuous radiotherapy to total

dose of 50～55 Gy; 192Ir high dose rate after loading unit

was used for branchytherapy after 3 weeks of external

radiotherapy at the dose in A point of 6 Gy per time for total

6 ～ 7 times. The patients of radiotherapy group were only

received radiotherapy with the same dose and same methods.

Results The effect rates of the chemoradiotherapy group and

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radiotherapy group were 96.6% and 86.2% respectively at the end

of the radiotherapy with no difference significantly

(P>0.05); Three months after radiotherapy the effect rates

in both groups were 96.6% and 65.5% ，showing a significant

difference (P<0.05). The overall 3 year，5 year survival

rates for the patients in chemoradiotherapy group and

radiotherapy group were 79.3% ， 68.9% and 62.1% ， 51.7%

respectively，P<0.05. Disease free survival rates were

62.1% and 41.4% respectively, P<0.05. Pelvic recurrence

rates were 31.0% and 17.2% respectively P<0.05. More serious

side effects were found in the chemoradiotherapy group.

Especially in bone marrow inhibition and reaction of digestive

tract, Which could be alleviated. Conclusion Concurrent

chemotherapy and radiotherapy in medium term and advanced

cervical carcinoma can increase treatment effect and raise the

survival of the patients ,obviously improve the short term

curative effect. Toxicity of patients was increasing but the

patients could tolerate.

Key words ： Cervical cancer ； Concurrent

chemoradiotherapy；Theraputic effect；Adverse effect

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