摘要
目的 观察宫颈癌术后不同因素对放疗远期疗效的影响。方法 1998年收治的各期宫颈癌共525例，其中346例手术治疗，术后放疗者302例。302例分布在Ⅰ、Ⅱa、Ⅱb、Ⅲa期，分别为142、121、23、16例。术后放疗采用^60Coγ线或6MVX线前后野垂直交替照射44～50Gy4～5周。根据存在的因素情况酌情扩大射野、缩野加照或阴道后装治疗及少数给予辅助化疗。结果 Ⅰ、Ⅱa、Ⅱb、Ⅲa期5年生存率分别为89．4％、77．7％、56．5％、56．2％（X^2=22．22，P〈0．01）。浸润浅层、深肌层、全层的5年生存率分别为94．8％、83．1％、62．7％（x0=27．46，P〈0．01）。盆腔内淋巴结转移、脉管瘤栓、残端及宫旁切缘呈阳性的有与无者5年生存率分别为52．3％与88．2％（X^2=41．79，P〈0．01）。结论 对术后有多种影响因素的患者，术后放疗是必要的，它可减少盆腔复发率。凡认为手术是宫颈癌主要治疗手段，有术后放化疗就可放宽手术适应证是不可取的。
Objective To evaluate the impact of different factors on long-term results in cervical carcinoma patients initially treated by surgery followed by radiotherapy. Methods In 1998, 525 cervical carcinoma patients were admitted, among whom 346 patients were first treated by surgery. 302 of these 525 patients were given postoperative radiotherapy. The stage distribution of these 302 patients were： stage Ⅰ 142;stage Ⅱ a 121;stage Ⅱ b 23;and stage Ⅲ a 16.^60Coγ or 6 MV X-ray was used for radiotherapy. Perpendicular portals were alternately irradiated to 44-50 Gy/4-5 week. Extending the portal, increasing the dose after constricting portal, adding intracavitary afterloading irradiation and adjuvant chemotherapy were carried out according to the different clinical requirements. Results The S-year survival rate was 89.4% ,77.7%,56.5% and56.3% instageⅠ, Ⅱa, Ⅱ band Ⅲ a lesion, respectively（X^2 = 22.22, P 〈 0.01）. The 5-year survival rate was 94.8% ,83.1% ,62.7% for invasion of the superficial muscles, deep muscles and all layers of muscles, respectively（X^2 = 27.46, P 〈 0.01 ）. The 5-year survival rate was 52.3% of patients with pelvic lymph node metastasis, vaginal positive stump and vasculitis carcinomaembolus, but88.2% forpatientswithoutthesefactors（X^2=41.79, P〈0.01）. Conclusions Postoperative radiotherapy is necessary for operated cervical carcinoma patients with different factors, as it may be lower the pelvic recurrence rate. Yet, unreasonable light broadening the indications of surgery because there is postoperative radiotherapy and chemotherapy, although surgery being the chief means of cure, is not warranted.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第2期120-122,共3页
Chinese Journal of Radiation Oncology
