CAJ | 학술논문

目的：探讨早期宫颈鳞癌术后伴有低危复发因素患者减少不良反应的最佳处理方式。方法：选取2008年2月至2012年3月山东省肿瘤医院共收治经术后病理证实，伴有1～2个低危不良预后因素的早期宫颈鳞癌患者133例。根据术后治疗方式不同分为单纯放疗组（42例）、化疗+后装治疗组（47例）和同步放化疗组（44例），比较3组患者的无疾病生存率和治疗相关并发症发生率。结果：随访时间为6～55个月，中位随访时间30个月。单纯放疗组、化疗+后装治疗组和同步放化疗组3年无疾病生存率分别为94.0％、93.4％和97.6％，差异无统计学意义（P>0.05）。3组急性重度不良反应（Ⅲ～Ⅳ级）发生率分别为9.5％、16.7％和34.1％，同步放化疗组Ⅲ～Ⅳ级不良反应发生率显著高于单纯放疗组和化疗+后装治疗组（P<0.05），而单纯放疗组与化疗+后装治疗组之间差异无统计学意义（P>0.05）。3组Ⅰ～Ⅱ度慢性放射性反应发生率分别为19.0％、4.3％和25.0％，单纯放疗组和同步放化疗组显著高于化疗+后装治疗组（P<0.05），单纯放疗组与同步放化疗组比较差异无统计学意义（P>0.05）。结论：对于早期低危宫颈鳞癌患者，与同步放化疗相比，术后采用化疗+后装治疗或单纯放疗均能够取得理想的治疗效果，而治疗相关并发症发生率明显降低。
목적：탐토조기궁경린암술후반유저위복발인소환자감소불량반응적최가처리방식。방법：선취2008년2월지2012년3월산동성종류의원공수치경술후병리증실，반유1～2개저위불량예후인소적조기궁경린암환자133례。근거술후치료방식불동분위단순방료조（42례）、화료+후장치료조（47례）화동보방화료조（44례），비교3조환자적무질병생존솔화치료상관병발증발생솔。결과：수방시간위6～55개월，중위수방시간30개월。단순방료조、화료+후장치료조화동보방화료조3년무질병생존솔분별위94.0％、93.4％화97.6％，차이무통계학의의（P>0.05）。3조급성중도불량반응（Ⅲ～Ⅳ급）발생솔분별위9.5％、16.7％화34.1％，동보방화료조Ⅲ～Ⅳ급불량반응발생솔현저고우단순방료조화화료+후장치료조（P<0.05），이단순방료조여화료+후장치료조지간차이무통계학의의（P>0.05）。3조Ⅰ～Ⅱ도만성방사성반응발생솔분별위19.0％、4.3％화25.0％，단순방료조화동보방화료조현저고우화료+후장치료조（P<0.05），단순방료조여동보방화료조비교차이무통계학의의（P>0.05）。결론：대우조기저위궁경린암환자，여동보방화료상비，술후채용화료+후장치료혹단순방료균능구취득이상적치료효과，이치료상관병발증발생솔명현강저。
Objective:The benefits of postoperative adjuvant therapy method for low-risk early-stage cervical squamous cell carcinoma were investigated. Methods:A total of 133 patients with low-risk early-stage cervical squamous cell carcinoma were treated at Shandong Cancer Hospital&Institute from February 2008 to March 2012. All patients received adjuvant therapy:42 were treated with pelvic ra-diotherapy (RT), 47 were treated with adjuvant chemotherapy (CT)+intracavitary radiotherapy (ICRT), and 44 were treated with concurrent chemoradiation (CCRT). Disease-free survival (DFS) and complications of the therapy were evaluated. Results:No significant differences in DFS were observed in the patients treated with RT, CT+ICRT, and CCRT (P>0.05), and the three-year DFS rates were 94.0%, 93.4%, and 97.6%, respectively. The frequencies of grade III to IV acute toxicities were significantly higher in patients treated with CCRT (34.1%) than in those treated with RT (9.5%) or CT+ICRT (16.7%) (P<0.05). No statistically significant difference was observed between the RT group and the CT+ICRT group (P>0.05). Grade I to II late toxicity was significantly more frequent in the CCRT (25%) and RT (19.0%) groups compared with the CT+ICRT group (4.3%) (P>0.05), but no statistically significant differences were observed between the CCRT and the RT groups (P>0.05). Conclusion:CT+ICRT or RT has a three-year DFS rate equivalent to CCRT but with fewer therapy com-plications for low-risk early-stage cervical squamous cell carcinoma.