摘要
目的观察子宫预癌术后放疗的疗效及预后。方法 1983年8月—2003年5月收治子宫颈癌术后患者180例,术前临床分期Ⅰ期128例,Ⅱa期52例。根据病情将患者分为2组,一组为术后及时放疗组,共131例,因宫颈癌术后有盆腔淋巴结转移、残端或宫旁残留癌、深肌层受侵,病理分化差、脉管有瘤栓高危因素而在术后1个月内追加放疗;另一组为术后复发或未控再放疗组,共49例,治疗时间为术后3个月～3年,半均9个月,全部患者均采用外照射加腔内治疗。结果 180例子宫颈癌患者术后放疗总5年生存率为61.11%,其中术后及时放疗组为74.05%。术后复发再放疗组为26.53%,2组差异有统计学意义(P<0.01)。Ⅰb期5年生存率为77.34%,Ⅱa期为21.15%,差异有统计学意义(P<0.01)。完全缓解125例,5年生存率为8 6.4%,部分缓解42例,5年生存率为4.76%,稳定或进展13例,5年生存率为0%(P<0.01)。鳞癌组与腺癌组疗效相近(P>0.05)。结论临床分期、术后放疗是否及时、放疗后近期疗效及未控复发肿瘤大小是判断患者预后的重要因素。因此,子宫颈癌术后有高危因素者应及时放疗,对术后放疗后近期疗效差者,应再追加化疗,能否提高疗效有侍于进一步研究。
Objective To evaluate the efficacy cancer by surgery and followed radiotherapy. Methods and prognosis of combined therapy of cervical Radiotherapy after surgery was administered to 180 patients with cervical cancer stage Ⅰb - Ⅱ a in the Fourth Hospital of Hebei Medical University from 1983 to 2003. There were 128 cases in stage Ⅰ b,52 cases in stage Ⅱ A. The patients were divided into two groups. There were 131 cases in group A who were treated by radiotherapy after surgery within one month because of some high risk factors including pelvic node metastases, with positive or close surgical margins, depth of stromal invasion 〉 1/3 the cervical wall, grade 3 tumor and presence of lymphovascular space involvement. In group B there were 49 cases with pelvis or vaginal vault recurrences. The treatment time ranged from 3 months to 3 years, with an average of 9 month, after surgery. All of the patients were treated with ;ntracavitary therapy combined external radiation therapy. Results The overall 5 -year survival rate was 61.11%, with 74.05 % for group A,26.53% for group B. The differences between these two groups were statistically significant （P 〈 0.01 ）. The 5 - year survival rates of stage Ⅰ b and stage Ⅱa were 77.34% and 21.15% respectively, with P 〈 0.01. The 5 - year survival rates of patients with complete response （ CR）, partial response （ PR ）, no response （ NR ）, or progressive disease （PD） were 86.4% ,4.76% and 0% respectively, with P 〈 0.01. The 5 - year survival rates of patients with squamous cell carcinoma and adenocarcinoma were similar, with P 〉 0. 05.Conclusion FIGO （the International Federation of Gynecology and Obstetrics ） stage, postoperative radiotherapy time and curative effects of postoperative radiotherapy in the near future may act as prognostic factors. Therefore if there were some high -risk factors in the patients, they should be treated by radiotherapy after surgery in time. If the curative effects of postoperative radiotherapy in some patients were poor, it is necessary to combine with chemotherapy.
出处
《河北医科大学学报》
CAS
2011年第10期1140-1142,共3页
Journal of Hebei Medical University
关键词
子宫肿瘤
放射疗法
治疗结果
uterine neoplasms
radiotherapy
treatment outcome
