摘要
目的探讨以^(125)I粒子植入和单纯化疗为基础的不同治疗模式对放疗后盆腔复发宫颈癌的局部疗效。方法回顾性分析2020年4月至2023年4月该院46例放疗后盆腔复发宫颈癌患者临床资料,根据治疗方式的不同分为粒子植入组(^(125)I粒子植入联合或未联合化疗,n=29)和单纯化疗组(n=17)。评估治疗前、治疗后1个月两组癌痛发生率和数字分级评分法(NRS)评分,比较两组客观缓解率(ORR),分析局部无进展生存(LPFS)时间的影响因素、粒子植入组Kaplan-Meier生存情况及不良反应发生情况。结果治疗后1个月,粒子植入组NRS评分较治疗前降低,且低于单纯化疗组(P<0.05)。粒子植入组3、6个月ORR较单纯化疗组更高(P<0.05)。46例患者LPFS时间为3~38个月,中位10个月,1、2年LPFS率为43%、19%。多因素Cox回归分析结果显示,肿块最大径、粒子植入是LPFS时间的影响因素(P<0.05)。粒子植入组LPFS时间为3~38个月,中位14个月,1、2年LPFS率为61%、22%。肿块最大径<2.5 cm、D_(90)>127.5 Gy、粒子植入联合化疗患者的中位LPFS时间更长(P<0.05)。粒子植入主要不良反应为短暂性局部疼痛,积极治疗后均快速缓解。结论^(125)I粒子植入联合化疗可改善放疗后盆腔复发宫颈癌的局部疗效。
Objective To investigate the local efficacy of different treatment regimens based on ^(125)I seed implantation and chemotherapy alone in the treatment of pelvic recurrent cervical cancer after radiotherapy.Methods The clinical data of 46 patients with pelvic recurrent cervical cancer after radiotherapy admitted to the hospital from April 2020 to April 2023 were retrospectively analyzed.According to different treatment methods,the patients were divided into the seed implantation group(^(125)I seed implantation combined with/without chemotherapy,n=29)and the chemotherapy alone group(n=17).The incidence of cancer pain and the Numerical Rating Scale(NRS)score of the two groups were evaluated before treatment and 1 month after treatment.The objective response rate(ORR)was compared between the 2 groups.The influencing factors of local progression-free survival(LPFS)time,as well as the Kaplan-Meier survival status and the occurrence of adverse reactions in the seed implantation group were analyzed.Results One month after treatment,the NRS score in the seed implantation group was lower than that before treatment and that in the chemotherapy alone group(P<0.05).The ORR of the seed implantation group at 3 and 6 months was significantly higher than that of the chemotherapy alone group(P<0.05).The LPFS time of the 46 patients ranged from 3 to 38 months,with a median of 10 months,and the 1-and 2-year LPFS rates were 43%and 19%,respectively.Multivariate Cox regression analysis showed that the maximum tumor diameter and ^(125)I seed implantation were the influencing factors of LPFS time(P<0.05).In the seed implantation group,the LPFS time ranged from 3 to 38 months with a median of 14 months,and the 1-and 2-year LPFS rates were 61%and 22%,respectively.Patients with a maximum tumor diameter<2.5 cm,D_(90)>127.5 Gy,and those receiving ^(125)I seed implantation combined with chemotherapy had a longer median LPFS time(P<0.05).The main adverse reaction in the seed implantation group was transient local pain,which was rapidly relieved after active treatment.Conclusion ^(125)I seed implantation combined with chemotherapy can improve the local efficacy in the treatment of pelvic recurrent cervical cancer after radiotherapy.
作者
罗爱华
闫卿
杨智杰
李欣
LUO Aihua;YAN Qing;YANG Zhijie;LI Xin(Department of Oncology,The Second People’s Hospital of Yichang/The Second People’s Hospital of China Three Gorges University,Yichang,Hubei 443000,China)
出处
《重庆医学》
2026年第2期363-368,共6页
Chongqing Medical Journal
基金
湖北省宜昌市医疗卫生科技项目(A21-2-033)。
关键词
放疗
盆腔复发宫颈癌
^(125)I
粒子植入
化疗
疗效
radiotherapy
pelvic recurrent cervical cancer
^(125)I
seed implantation
chemotherapy
efficacy
