摘要
目的探讨介入性动脉化疗栓塞序贯盆腔根治性放疗治疗中晚期宫颈癌的临床应用价值。方法195例临床Ⅱb期以上的中晚期宫颈癌患者,根据治疗方法不同分为介入化疗栓塞联合放疗组(联合组)99例和单纯放疗组(放疗组)96例,比较治疗后的近、远期疗效及并发症等各项指标,评价两组在治疗中晚期宫颈癌上的效果和差异。结果治疗后两组瘤体均出现不同程度缩小,但近期缓解率联合组高于放疗组,组间比较差异有统计学意义(P=0.012);联合组介入术后贫血纠正明显,术前、术后血红蛋白水平差异有显著统计学意义(P<0.01)。远期随访3年生存率联合组高于放疗组(P=0.032),1、3年肿瘤复发转移率联合组明显低于放疗组(P<0.05);1、5年生存率及5年肿瘤复发率两组差异无统计学意义。近期并发症主要表现为消化道反应,骨髓抑制及肝、肾毒性等不良反应,经临床积极对症处理后均能缓解。远期并发症以放射性皮炎、膀胱炎和(或)直肠炎为主,其中联合组放射性膀胱炎和直肠炎的发生率均低于放疗组(P<0.05)。结论介入化疗栓塞序贯放疗是治疗中晚期宫颈癌的有效方法,可以提高近远期疗效,改善临床症状,降低远期并发症,提高患者生活质量,延长患者生存期。
Objective To discuss the clinical value of interventional transcatheter arterial chemoembolization （TACE） combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer. Methods According to the therapeutic scheme, 195 patients with phase IIb or beyond advanced cervical cancer were divided into two groups： （1） study group （n = 99）, treated with TACE combined with subsequent pelvic radiotherapy （i.e. combination group）;（2） control group（n = 96）, treated with radiotherapy alone （i.e. radiotherapy alone group）. The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups. Results Different degrees of the tumor shrinkage were found in patients of both groups after treatment. The short-term remission rate of the study group was significantly higher than that of the control group, and the difference between two groups was statistically significant （P = 0.012）. After the procedure, the anaemia in patients of study group was markedly corrected. The difference in hemoglobin between preoperative levels and postoperative ones was significant （T-test, P〈0.01）. Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group （P = 0.032）. Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group （P〈0.05）. No significant difference in one-year, five-year survival rate and in five-year recurrent rate existed between two groups. The main short-term complications included digestive untoward reaction, bone marrow depression, hepatic and renal toxicity, etc., which could be well relieved after active symptomatic medication. The long-term complications included radiodermatitis, radiocystitis and / or radioproctitis. The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group （P〈0.05）.Conclusion TACE combined with subsequent pelvic radiotherapy is an effective therapy for advanced cervical cancer, its clinical result is superior to simple radiotherapy. This therapy can enhance both the short-term and the long-term effects, relieve the clinical symptoms, reduce the occurrence of long-term complications, thus, improve the quality of life and prolong the survival time of patients.
出处
《介入放射学杂志》
CSCD
北大核心
2010年第3期194-197,共4页
Journal of Interventional Radiology
关键词
宫颈癌
介入
化疗
栓塞
放疗
intervention
chemotherapy
embolization
radiotherapy
cervical cancer
