CAJ | 학술논문

目的探讨同步放化疗治疗ⅡB～ⅢB期子宫颈癌的疗效.方法将126例ⅡB～ⅢB期子宫颈癌患者随机分为同步放化疗组(治疗组)和化疗后放疗组(对照组).对照组62例外照射加腔内治疗,当放疗剂量达到30Gy时用192Ir腔内治疗,7.0Gy/次,1次/周.当外照射剂量达到46 Gy时中间挡铅.A点剂量65～70 Gy,B点剂量50～56Gy结束放疗,在放疗开始前给予顺铂(DDP)20mg静脉滴注,第1天至第5天,5-氟尿嘧啶(5-Fu)750mg静脉滴注,第1天至第5天,每28 d重复.2个周期结束后开始放疗,放疗结束后继续原方案化疗2个周期,共4个周期.治疗组64例,放射治疗同对照组,在放疗开始时给予DDP 20 mg静脉滴注,第1天至第5天,5-Fu 750 mg静脉滴注,第1天至第5天,每28 d重复,共用4个周期.结果全部病例随访5年以上,随访率94.4%.治疗组3、5年生存率分别为82.8%、65.6%;对照组3、5年生存率分别为67.7%、46.8%,两组差异有统计学意义(x2=3.86,P＜0.05;x2=5.01,P＜0.05).两组生存曲线比较差异有统计学意义(x2=4.26,P＜0.05),不良反应差异无统计学意义.结论同步放化疗治疗晚期子宫颈癌疗效好,可以提高3、5年生存率.不良反应无明显增加.
목적 탐토동보방화료치료ⅡB～ⅢB기자궁경암적료효.방법 장126례ⅡB～ⅢB기자궁경암환자수궤분위동보방화료조(치료조)화화료후방료조(대조조).대조조62예외조사가강내치료,당방료제량체도30Gy시용192Ir강내치료,7.0Gy/차,1차/주.당외조사제량체도46 Gy시중간당연.A점제량65～70 Gy,B점제량50～56Gy결속방료,재방료개시전급여순박(DDP)20mg정맥적주,제1천지제5천,5-불뇨밀정(5-Fu)750mg정맥적주,제1천지제5천,매28 d중복.2개주기결속후개시방료,방료결속후계속원방안화료2개주기,공4개주기.치료조64례,방사치료동대조조,재방료개시시급여DDP 20 mg정맥적주,제1천지제5천,5-Fu 750 mg정맥적주,제1천지제5천,매28 d중복,공용4개주기.결과 전부병례수방5년이상,수방솔94.4%.치료조3、5년생존솔분별위82.8%、65.6%;대조조3、5년생존솔분별위67.7%、46.8%,량조차이유통계학의의(x2=3.86,P＜0.05;x2=5.01,P＜0.05).량조생존곡선비교차이유통계학의의(x2=4.26,P＜0.05),불량반응차이무통계학의의.결론 동보방화료치료만기자궁경암료효호,가이제고3、5년생존솔.불량반응무명현증가.
Objective To observe the effect and side effects of concurrent chemoradiotherapy for stage ⅡB～ⅢB cervical cancer. Methods 126 patients with stage ⅡB～ⅢB cervical cancer were randomly allocated into 2 groups. Concurrent chemoradiotherapy group: radiotherapy carried out same as the neoadjuvant chemotherapy group, i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 4 cycle; the neoadjuvant chemotherapy group i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 2 cycle, after chemotherapy received routine radiotherapy 2 Gy per day, 5 times a week to a total dose of 30 Gy with 192Ir brachytherapy, 7 Gy per week. When total dose reached 46 Gy, the middle field was shielded by plumbum, then continuous radiotherapy, total dose reach A point 65-70 Gy, B point 50-56 Gy. Results All patients were followed-up for more than five years. The follow-up rate was 94.4 %. In concurrent chemoradiotherapy group the 3 year survival rate and the 5 year survival rate were 82.8 %, 65.6 %, In neoadjuvant chemotherapy group the 3 year survival rate and the 5 year survival rate were 67.7 %, 46.8 %. There was a significant difference in two groups (X2=3.86, P＜0.05; X2=5.01, P＜0.05), no significant difference in toxicity-side effect. Conclusion Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 3-year and 5-year survival rate and has little increase in toxicity-side effect.