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目的探讨影响中晚期宫颈癌同步放化疗疗效的临床病理因素。方法回顾性分析2000-01-01-2006-12-30广西医科大学肿瘤医院妇瘤科收治的经病理确诊且资料完整的88例接受了首次同步放化疗的ⅡB～Ⅳ期宫颈癌患者的临床资料;同时与同期收治的70例行非同步放化疗的ⅡB～Ⅳ期宫颈癌患者进行对比分析。结果(1)同步放化疗组的累积生存率:1、3、5年的生存率分别为89.77%、63.91%、50.03%,中位生存期56个月;非同步放化疗组的累积生存率:1、3、5年的生存率分别为90.00%、47.36%、29.09%,中位生存期(34个月),两组比较差异有统计学意义(P=0.005)。(2)非同步放化疗患者的复发率(15.71%)高于同步放化疗组(4.55%),差异有统计学意义(P=0.017)。(3)顺铂(DDP)增敏化疗的次数、DDP总剂量/总治疗时间比值、外照射放疗(EBRT)总剂量/总治疗时间(OTT)比值是影响中晚期宫颈癌同步放化疗疗效的因素。(4)多因素分析提示肿瘤的病理类型(P<0.1)、DDP总剂量/总治疗时间比值(P<0.05)、EBRT总剂量/OTT比值(P<0.1)是决定预后的独立因素。结论同步放化疗能改善中晚期宫颈癌患者预后,而肿瘤的病理类型、DDP总剂量/总治疗时间比值和EBRT总剂量/OTT比值是影响其疗效的重要因素。
Objective To investigate the clinicopathological factors that affect the efficacy of concurrent chemoradiotherapy in advanced cervical cancer. Methods Retrospective analysis of 88 patients with stage ⅡB ~ Ⅳ cervical cancer admitted to Department of Gynecology and Oncology, Guangxi Medical University, 2000-01-01-2006-12-30. Data were compared with 70 patients with stage IIB-IV cervical cancer undergoing concurrent chemoradiotherapy admitted in the same period. Results (1) The cumulative survival rates of concurrent chemoradiotherapy group were 89.77%, 63.91%, 50.03%, respectively. The median survival time was 56 months. The cumulative survival rate The survival rates at 1, 3 and 5 years were 90.00%, 47.36% and 29.09% respectively, and the median survival time was 34 months. The difference between the two groups was statistically significant (P = 0.005). (2) The recurrence rate of non-synchronous chemoradiotherapy patients (15.71%) was higher than that of concurrent chemoradiotherapy patients (4.55%), the difference was statistically significant (P = 0.017). (3) The frequency of chemosensitivity chemotherapy, the ratio of DDP to total treatment time, the total dose of EBRT and the total treatment time (OTT) ratio of cisplatin (DDP) are the effects of concurrent chemoradiotherapy in advanced cervical cancer. factor. (4) Multivariate analysis showed that the pathological type of tumor (P <0.1), total DDP / total treatment time (P <0.05) and total EBRT dose / OTT ratio (P <0.1) were independent prognostic factors. Conclusions Simultaneous chemoradiotherapy can improve the prognosis of patients with advanced cervical cancer. The pathological type, total DDP / total treatment time and total EBRT / OTT ratio are the important factors affecting the curative effect.