CAJ | 학술논문

目的探讨同步放化疗治疗中晚期子宫颈癌的临床疗效.方法选取中晚期子宫颈癌病例168例.将病理确诊为Ⅱ～Ⅳ期的84例作为放化组(A组),化疗用顺铂(DDP)每周40mg/m2,静脉滴注,同时配合止吐、水化等治疗,共3～4个周期.同时行根治性放疗:60Co-γ线体外照射,总剂量为50 Gy.腔内后装采用,'192>Ir后装机,A点7Gy/周,总剂量为42 Gy.以同期收治、条件相同行单纯放疗的中晚期子宫颈癌患者84例为对照组(B组),根治性放疗方法同A组.观察两近期疗效、2年生存率及放化疗并发症.结果放疗3个月后,A组的有效率为92.85%(78/84);B组的有效率为79.76%(67/84),两组差异有统计学意义(χ2=6.10,P<0.05).A组2年生存率(83.95%)明显高于B组(60.98%)(χ2=9.4,P<0.005).A组局部复发率、远处转移率明显低于B组.A组虽有较明显的骨髓抑制、消化道反应,但均可耐受.结论同步放化疗能明显提高中晚期子宫颈癌的生存率,应用DDP安全可行,不良反应患者可耐受,但远期疗效需进一步观察.
목적 탐토동보방화료치료중만기자궁경암적림상료효.방법 선취중만기자궁경암병례168례.장병리학진위Ⅱ～Ⅳ기적84례작위방화조(A조),화료용순박(DDP)매주40mg/m2,정맥적주,동시배합지토、수화등치료,공3～4개주기.동시행근치성방료:60Co-γ선체외조사,총제량위50 Gy.강내후장채용,'192>Ir후장궤,A점7Gy/주,총제량위42 Gy.이동기수치、조건상동행단순방료적중만기자궁경암환자84례위대조조(B조),근치성방료방법동A조.관찰량근기료효、2년생존솔급방화료병발증.결과 방료3개월후,A조적유효솔위92.85%(78/84);B조적유효솔위79.76%(67/84),량조차이유통계학의의(χ2=6.10,P<0.05).A조2년생존솔(83.95%)명현고우B조(60.98%)(χ2=9.4,P<0.005).A조국부복발솔、원처전이솔명현저우B조.A조수유교명현적골수억제、소화도반응,단균가내수.결론 동보방화료능명현제고중만기자궁경암적생존솔,응용DDP안전가행,불량반응환자가내수,단원기료효수진일보관찰.
Objective To investigate the curative effect of synchronous radio-chemotherapy in medium-term and advanced cervical carcinoma. Methods 168 cases of medium-term and advanced cervical carcinoma were selected. The treatment group(grout A) included 84 pathologically verified cases of stage Ⅱ～Ⅳ cervical carcinoma. Each patient was given DDP with hydration at the dose of 40 mg/m2 intravenously.The treatment cycle was performed once every week for 3--4 circles. Radiotherapy was given at the same time. 60Co was used for external radiation with a total dose of 50 Gy, 192 Ir afterloading unit was used for brachytherapy at the dose of 7 Gy per week at point A with a total dose of 42 Gy. The control group (group B)included 84 cases of cervical carcinoma at the same stage in the corresponding period who received radiotherapy only.Short-term effect ,2-year survival rate and complications were observed. Results Effective rate was 92.85 %(78/84) in group A and 79.76 %(67/84) in group B respectively 3 months after radiotherapy, showing a significant difference(χ2 =6.10,P <0.05). 2-year survival rate was higher in group A (83.95 %) than in Group B(60.98 %) (χ2 =9.4,P<0.05). Local recurrent and distant metastasis were lower in Group A than Group B. In group A, there were tolerable bone marrow inhibition and reaction of digestive tract. Conclusion Synchronous radiotherapy and chemotherapy can remarkably improve the survival rate of medium-term and advanced cervical carcinoma. The application of DDP is effective and safe,and its side effect can be accepted by patients, but the long-term effect needs further observation.