摘要
目的分析子宫颈癌放疗后宫腔积液患者的临床特点。方法回顾性分析151例子宫颈癌放疗后发生宫腔积液患者的临床资料。结果151例患者的宫颈癌临床分期为ⅡB、ⅢB期;其中宫颈腺癌32例。151例中阴道分泌物增多是主要临床症状共65例,阴道血性分泌物或阴道不规则出血32例,患者自己发现下腹部肿物27例,另27例无任何临床症状。B超检查发现宫腔积液阳性率为100%。64例为放疗后单纯宫腔积液,其中8例为宫腔积脓,除17例行子宫双附件切除外,余经扩宫引流后逐渐消失;62例为肿瘤未控或复发合并宫腔积液,19例行全子宫双附件切除,余接受补充放疗或姑息性化疗;25例为放射后发肿瘤合并宫腔积液,以全宫双附件切除,术后辅助化疗为主。三组患者中64例单纯宫腔积液的预后最好,5年生存率为54.8%。35例肿瘤未控者5年生存率为0%;27例肿瘤复发后的5年生存率为28.7%;25例放射后发肿瘤者5年生存率为47.5%,其中癌肉瘤的为0%。单纯宫腔积液的预后相对较好,放射后发肿瘤的预后次之,宫颈癌未控或复发的预后最差。结论宫颈癌放疗后出现的宫腔积液常伴有肿瘤存在,预后与是否有肿瘤因素有关。
Objective To analyse the clinical characteristics of patients with uterus effusion after irradiation for carcinoma of the cervix. Methods 151 patients with uterus effusion after irradiation for carcinoma of the cervix were retrospectively analyzed. Results All these 151 patients who had been treated by radiotherapy had FIGO stage ⅡB or ⅢB lesions including 32 adenocarcinomas. The most common symptom was irregular vaginal discharge or drainage （65 patients） , followed by irregular vaginal bleeding （32 patients） ,and abdominal or pelvic mass （ 27 patients ）. Twenty-seven patients were entirely asymptomatic. The positive rate of uterus effusion found by B-ultrasound scan was 100%. When uterus effusion was found, 87 patients （57.6%） had malignant tumor, including 62 with residual or recurrent cervical carcinoma and 25 with secondary primary malignant uterus tumor. Sixty-four patients had uterus effusion alone including 8 with pyometra. Of these 64 patients, 17 underwent abdominal hysterectomy with bilateral salpingo-oophorectomy （ BSOH ）, the others were treated with drainage till the fluid disappeared. Of the 62 patients with residual or recurrent cervical carcinoma, 19 underwent BSOH and 43 were treated by palliative irradiation or chemotherapy. Twenty-five patients who had secondary primary malignant uterus tumor were treated by BSOH. The 5-year survival rate of patients with uterus effusion alone, with residual tumor （ with recurrent tumor） , or with secondary primary malignancy were 54.8% , 0% , 28.7% and 47.5% , respectively. The prognosis of the patients with uterus effusion alone was better than those with secondary primary malignant uterus tumor. Patients with residual or recurrent cervical cancer had the worst prognosis. Conclusions Patients with uterus effusion after irradiation for carcinoma of the cervix often have tumor including secondary primary malignant uterus tumor. The prognosis is different, which depends on if the patient has tumor or not.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2007年第6期451-454,共4页
Chinese Journal of Radiation Oncology
关键词
子宫颈癌
放射治疗
宫腔积液
肿瘤未控
肿瘤复发
放射后发肿瘤
Cervical neoplasms/radiotherapy
Uterine fluid
neoplasm persistence
neoplasm recurrence
Second neoplasm
