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手术联合放化疗治疗宫颈癌患者的预后及影响因素:一项回顾性研究。

Outcome and prognostic factors in cervical cancer patients treated with surgery and concurrent chemoradiotherapy: a retrospective study.

机构信息

Department of Radiation Oncology, Tai Zhou Central Hospital, Tai Zhou, Zhe Jiang, 318000, China.

Department of Obstetrics and Gynecology, Tai Zhou Central Hospital, Tai Zhou, Zhe Jiang, 318000, China.

出版信息

World J Surg Oncol. 2018 Jan 29;16(1):18. doi: 10.1186/s12957-017-1307-0.

Abstract

BACKGROUND

The objective of this study is to analyze the treatment outcome and secondary reactions in 98 patients with stage I-III cervical carcinoma who underwent postoperative radiotherapy.

METHODS

From 2006 to 2014, 98 patients with stage I-III cervical carcinoma were treated with postoperative radiotherapy. The major histological type, found in 92.86% of the patients (91 cases), was squamous cell carcinoma. Patients were staged according to the 2002 TNM guidelines. The postoperative radiotherapy methods included two-field irradiation (16 patients, 16.32%), four-field box irradiation (16 patients, 16.32%), and intensity-modulated radiotherapy (IMRT; 66 patients, 67.36%). The survival rates were represented using Kaplan-Meier curves, and prognosis analyses were performed using Cox multivariate analyses.

RESULTS

The 5-year overall survival and progression-free survival rates were 82.0 and 76.0%, respectively. Only one patient (1.02%) developed a grade 3 acute radiation enteritis, while grade 3 and 4 myelosuppression was noted in 17 patients (17.35%) and one patient (1.02%), respectively. Multivariate analyses showed that anemia before radiotherapy and tumor size were predictors of the OS (P = 0.008, P = 0.045) rates.

CONCLUSIONS

Postoperative radiotherapy for patients with risk factors of cervical cancer procured good efficacy levels with mild side effects. Anemia and tumor size were important OS predictors.

摘要

背景

本研究旨在分析 98 例Ⅰ-Ⅲ期宫颈癌术后放疗患者的治疗效果和不良反应。

方法

2006 年至 2014 年,对 98 例Ⅰ-Ⅲ期宫颈癌患者进行术后放疗。92.86%(91 例)的主要组织学类型为鳞状细胞癌。患者分期依据 2002 年 TNM 分期标准。术后放疗方法包括两野照射(16 例,16.32%)、四野箱照射(16 例,16.32%)和调强放疗(IMRT;66 例,67.36%)。采用 Kaplan-Meier 曲线表示生存率,采用 Cox 多因素分析进行预后分析。

结果

5 年总生存率和无进展生存率分别为 82.0%和 76.0%。仅 1 例(1.02%)发生 3 级急性放射性肠炎,17 例(17.35%)和 1 例(1.02%)分别发生 3 级和 4 级骨髓抑制。多因素分析显示,放疗前贫血和肿瘤大小是 OS(P=0.008,P=0.045)的预测因素。

结论

对宫颈癌高危因素患者进行术后放疗疗效较好,不良反应较轻。贫血和肿瘤大小是 OS 的重要预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/904e/5789695/3029564f338a/12957_2017_1307_Fig1_HTML.jpg

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