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【目的】比较早期巨块型宫颈癌腹盆腔深部热疗联合同步放化疗和同步放化疗的疗效和安全性之间的差异。【方法】收集2005年3月16日至2009年5月20日经中山大学附属第五医院治疗的ⅠB2期和巨块型ⅡA期的宫颈癌82例,随机分为腹盆腔热疗加同步放化疗组(42例)和同步放化疗组(40例)。两组放化疗方案一致:盆腔外照射(30Gy/15F)+腔内放疗(A点剂量36Gy/6F),同期静脉TP方案化疗2周期。热放化疗组采用区域深部热疗,2次/周,每次60 min,每次热疗均在放疗前1h内进行。【结果】热放化疗组完全缓解率、5年无复发生存率及5年生存率分别为88.1%、83%及85%,单纯放化疗组分别为70.0%、70%及75%,两组比较均有统计学意义,P值分别为0.043、0.049及0.039;远处转移率热放化疗组(4.7%)与放化疗组(10.0%)比较差异无统计学意义(P=0.397);骨髓抑制、膀胱及胃肠反应等毒副反应2组比较无显著差异(P>0.05)。【结论】与同期放化疗相比,局部热疗联合同步放化疗更能提高宫颈癌完全缓解率,提高5年生存率及无复发生存率,未增加远处转移机会,治疗毒副反应无明显增加,安全有效。
【Objective】 To compare the efficacy and safety of deep hyperthermia combined with concurrent chemoradiotherapy and concurrent chemoradiotherapy in the treatment of early massive cervical cancer. 【Methods】 Eighty-two cases of stage Ⅰ B 2 and giant-block Ⅱ A cervical cancer treated with the Fifth Affiliated Hospital of Sun Yat-sen University from March 16, 2005 to May 20, 2009 were collected and randomly divided into abdominal pelvic hyperthermia plus synchronous discharge Chemotherapy group (42 cases) and concurrent chemoradiotherapy group (40 cases). Both radiotherapy and chemotherapy regimens were the same: external pelvic irradiation (30Gy / 15F) + intracavitary radiotherapy (point A dose 36Gy / 6F) and intravenous TP regimen for 2 cycles. Radiotherapy and chemotherapy group with regional deep hyperthermia, 2 times / week, each 60 min, each hyperthermia were within 1h before radiotherapy. 【Results】 The complete remission rate, 5-year recurrence-free survival rate and 5-year survival rate were 88.1%, 83% and 85% in the radiotherapy and chemotherapy group, 70.0%, 70% and 75% in the radiotherapy and chemotherapy group, respectively (P = 0.397, P = 0.397, P = 0.043, 0.049 and 0.039, respectively). There was no significant difference between the radiotherapy and chemotherapy group (4.7%) and radiotherapy and chemotherapy group (10.0% Inhibition, bladder and gastrointestinal reactions and other side effects no significant difference between the two groups (P> 0.05). 【Conclusions】 Compared with concurrent chemoradiotherapy, local hyperthermia combined with concurrent chemoradiotherapy can improve the complete remission rate of cervical cancer, improve the 5-year survival rate and recurrence-free survival rate, increase the chance of distant metastasis, and have no obvious side effects in treatment Increase, safe and effective.