摘要
目的评价局部晚期宫颈癌（FIGO）同步放化疗后辅助化疗的疗效和晚期反应。方法回顾分析2008年1月～2011年4月我院收治的ⅡB～ⅢB期159例行根治性同步放化疗的宫颈癌患者，根据同步放化疗后是否行辅助化疗，分为同步放化疗（CCRT）组65例和同步放化疗联合辅助化疗（CCRT＋ACT）组94例。比较两组的局部无复发生存、总生存和3、4级的晚期放射损伤。结果两组中位随访时间均为64个月，CCRT组的1、3及5年局部无复发生存率分别为91．9％、84．6％和80．3％，CCRT＋ART组的1、3及5年局部无复发生存率分别为94．7％、84．7％和82．0％，两组总的局部无复发生存率比较，差异无统计学意义（P=0．822，）。CCRT＋ACT组较CCRT组明显提高了3、5年生存率（85．9％vs66．9％，P=0．03和70．3％VS53．7％，P=0．01）及总生存率（P=0．012）。3～4级晚期放射损伤，联合辅助化疗组略高，但差异无统计学意义（P〉0．05）。结论辅助化疗可以明显改善根治性同步放化疗后局部晚期宫颈癌患者的3、5年及总生存率，同时不增加晚期放射损伤。但仍需要更多的临床试验验证此结论。
Objective To evaluate the clinical effect and late toxicities of adjuvant chemotherapy in locally advanced cervical cancer after treatment with concomitant chemoradiotherapy. Methods 159 patients with stage II B-III B cervical cancer treated with radical concomitant ehemoradiotherapy at Dept. of Radiotherapy of Sichuan province cancer Hospital from January, 2008 to April, 2011 were retrospectively analysed and divided into Group CCRT： radical concomitant chemoradiotherapy （65cases） and Group CCRT＋ACT： radical concomitant chemoradiotherapy combined adjuvant chemotherapy （95 cases）. The local relapse-free survival rate （LRFS）, overall survival rate （OS）, and grade 3-4 late radiation toxicities were compared. Results Median follow-up of both groups were 64 months. The LRFS of group CCRT at 1 year, 3 years and 5 years were 91.9% ,84.6% and 80. 3%, respectively. The LRFS of group CCRT＋ACT at at 1year, 3 years and 5 years were 94.7%, 84.7% and 82.0 %, respectively. There was no significant difference between two groups, as were overall LRFS （log-rank P=0. 822）. OS of Group CCRT＋ACT at 3 years and 5 years were significantly improved versus Group CCRT （85.9% vs 66.9% ,P=0. 03, 70.3% vs 53.7% ,P=0. 01）, as were overall survival （log- rank P= 0. 012）. Grade 3-4 late radiation toxicities occurred a little more frequently in Group CCRT＋ ACT, but with no significant difference（P〉0.05）. Conclusion Concomitant chemoradiotherapy combined adjuvant chemotherapy could improve significantly OS of patients in locally advanced cervical cancer without significantly increasing late radiation toxicity when compared with concomitant chemoradiotherapy. More clinical trials are required to demonstrate the conclusion.
出处
《西部医学》
2016年第12期1711-1715,共5页
Medical Journal of West China
基金
四川省卫生厅科研课题(080392)
关键词
宫颈癌
同步放化疗
辅助化疗
治疗效果
Cervical cancer
Concomitant chemoradiotherapy
Adjuvant chemotherapy
Effect
