| 田素萍,孙文杰,史曙霞,等.同步放化疗与新辅助化疗 +同步放化疗续贯方案治疗 ⅡB~ⅢB期宫颈鳞癌疗效比较及预后因素分析[J].安徽医药,2021,25(8):1680-1683. |
| 同步放化疗与新辅助化疗 +同步放化疗续贯方案治疗 ⅡB~ⅢB期宫颈鳞癌疗效比较及预后因素分析 |
| Influence of two kinds of treatment regimens on clinical efficacy of patients with cervical squamous cell carcinoma for stage Ⅱ B-Ⅲ B and the prognostic factors |
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| DOI：10.3969/j.issn.1009-6469.2021.08.048 |
| 中文关键词: 宫颈肿瘤 同步放化疗 新辅助化疗 预后 |
| 英文关键词: Uterine cervical neoplasms Concurrent radichemotherapy Neoadjuvant chemotherapy Prognosis |
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| 摘要点击次数: 1829 |
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| 中文摘要: |
| 目的比较同步放化疗与新辅助化疗 +同步放化疗续贯方案治疗 ⅡB~ⅢB期宫颈鳞癌的疗效，并分析预后因素。方法选取济源市肿瘤医院 2008年 1月至 2013年 1月收治的 ⅡB~ⅢB期宫颈鳞癌病人 86例，其中 57例行同步放化疗方案设为 A组， 29例采用新辅助化疗 +同步放化疗续贯方案设为 B组。比较两组生存时间和毒副作用发生率，并根据淋巴结有无转移进行分层分析，同时对预后影响因素进行单因素和 Cox模型多因素分析。结果 A、B组随访 1年( 96.5%比 93.1%)、 3年( 80.7%比 75.9%)及 5年( 70.2%比 58.6%)生存率比较，差异无统计学意义( P>0.05)；淋巴结转移病人 B组盆腔局部复发率显著高于 A组( 25.0%比 0.0%，P<0.05)；无淋巴结转移病人两组治疗失败类型比较差异无统计学意义( P>0.05)；淋巴结转移病人两组毒副作用发生率比较差异无统计学意义( P>0.05)；无淋巴结转移病人 B组Ⅲ~Ⅳ级骨髓抑制发生率显著高于 A组( 52.9%比 31.7%， P<0.05)；单因素和 Cox多因素分析结果均证实，肿瘤长径、淋巴结转移情况及同步化疗方式是影响 ⅡB~ⅢB期宫颈鳞癌病人生存时间危险因素(P<0.05)。结论同步放化疗和新辅助化疗 +同步放化疗续贯方案对 ⅡB~ⅢB期宫颈鳞癌总体生存获益接近，其中肿瘤长径、淋巴结转移状态及同步化疗方式是影响病人临床预后危险因素；同时新辅助化疗可导致病人盆腔局部复发和Ⅲ~Ⅳ级骨髓抑制发生风险升高。 |
| 英文摘要: |
| Objective To investigate the influence of concurrent radiochemotherapy and neoadjuvant chemotherapy plus concurrentradiochemotherapy on clinical efficacy of patients with cervical squamous cell carcinoma for stage Ⅱ B-Ⅲ B and the prognostic factors. Methods A total of 86 patients with cervical squamous cell carcinoma for stage Ⅱ B-Ⅲ B were chosen, who were treated in the period from January 2008 to January 2013 in the Cancer Hospital of Jiyuan, and were assigned into 2 groups: group A (n=57) with concurrent radiochemotherapy used alone and group B (n=29) with neoadjuvant chemotherapy plus concurrent radiochemotherapy. The survival time and the incidence of toxic and side effects in both groups were compared and were analyzed by stratification according to lymphnode metastasis status and simultaneously the prognostic factors were analyzed by the Cox proportional hazards model.Results There were no significant differences in the survival rates in 1 (96.5% vs. 93.1%), 3 (80.7% vs. 75.9%) and 5 years (70.2% vs. 58.6%) of follow-up between groups A and B (P>0.05). The pelvic local recurrence rate of group B with lymph node metastasis was significantly higher than group A(25.0% vs. 0.0%,P<0.05). There was no significant difference in the treatment failure types between the two groupsof patients without lymph node metastasis(P>0.05). And there was no significant difference in the incidence of toxic and side effects between 2 groups of patients with lymph node metastasis(P>0.05). The grade Ⅲ-Ⅳ bone marrow suppression rate in group B of patientswithout lymph node metastasis was significantly higher than that in group A(52.9% vs. 31.7%,P<0.05). Univariate and multivariate Coxanalysis results confirmed that tumor size, lymph node metastasis and concurrent chemotherapy were risk factors for the survival time ofpatients with stage ⅡB-ⅢB cervical squamous cell carcinoma(P<0.05).Conclusions Concurrent radiochemotherapy and neoadjuvantchemotherapy plus concurrent radiochemotherapy in the treatment of patients with cervical squamous cell carcinoma for stage Ⅱ B-Ⅲ B possess the same total survival benefits. Tumor size, lymph node metastasis and concurrent chemotherapy are risk factors affectingthe clinical prognosis of patients and neoadjuvant chemotherapy plus concurrent radiochemotherapy may cause increased risk of localpelvic recurrence and grade Ⅲ-Ⅳ bone marrow suppression. |
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