目的 探讨不可手术宫颈浸润癌同步放化疗与单纯放疗近期疗效及安全性,评估患者的耐受性及生活质量的变化.方法 选择收治的Ⅱa~Ⅲ期子宫颈癌患者54例,按病理分为鳞癌49例,腺癌5例;按临床分期分为Ⅱa期8例,Ⅱb期15例,Ⅲ期31例.患者随机分为2组:A组29例,同步放化疗;B组25例,单纯放疗.比较2组患者近期疗效、血液学不良反应、非血液学不良反应、生活质量方面及治疗依从性.结果 54例患者全部完成治疗,无因治疗不良反应而退组或死亡,A组CR、PR、SD、PD分别是79.3%、6.9%、3.4%、10.3%,B组CR、PR、SD、PD分别是56.0%、12.0%、20.0%、12.0%.A组与B组有效率分别为86.2%、68.0%,差异均有统计学意义(P<0.05).A组骨髓抑制、放射性直肠膀胱反应及消化道反应发生率均高于B组(P<0.05).及时对症治疗后,患者均可耐受治疗.结论 同步放化疗治疗宫颈浸润癌可提高近期疗效;以铂类为基础的化疗参与到放疗中,患者能耐受,未出现重度的急性放射损伤,从治疗结果看,患者从联合化疗中获益,与化疗联合应用安全、有效,远期疗效及远期毒性反应尚有待进一步观察.%Objective To investigate and compare the short-term efficacy and safety between concurrent chemoradiotherapy and simple radiotherapy in treatment of invasive cervical cancer,and to evaluate the changes of tolerance and life quality of patients.Methods Fifty-four patients with invasive cervical cancer at stage Ⅱa~Ⅲ were randomly divided into two groups, concurrent chemoradiotherapy group (group A,n=29) and simple radiotherapy group (group B,n=25),including 49 cases of squamous cell carcinoma and 5 cases of adenocarcinoma by pathology,and 8 cases at stage Ⅱa,15 cases at stage Ⅱb,31 cases at stage Ⅲ according to the clinical staging.The short-term efficacy,hematological adverse reactions,non hematologic adverse reactions,life quality and treatment compliance were observed and compared between two groups.Results All the patients completed the planned treatment without withdrawing or death because of the side effects.The CR,PR,SD,PD in group A were 79.3%,6.9%,3.4%,10.3%,respectively,which were 56.0%, 12.0%,20.0%,12.0%,respectively in group B.There was a significant difference in effective rate between group A and group B (86.2% vs 68.0%,P<0.05).The incidence rates of bone marrow depression,radioactivity archo-cystitis and digestive tract reaction in group A were significantly higher than those in group B.Moreover,the patients in both groups had treatment tolerance well.Conclusion The concurrent chemoradiotherapy in treatment of invasive cervical cancer can increase short-term efficacy,with better treatment tolerance, obvious effectiveness and safety,without obvious acute radiation injury,however,its long-term outcomes and side effects still need to be observed further.
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