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中晚期宫颈癌子宫动脉介入化疗栓塞联合放疗的临床分析。

Clinical analysis of uterine arterial interventional chemoembolization combined with radiotherapy in mid-advanced cervical cancer.

机构信息

XinJiang Medical University, Urumqi, China.

出版信息

J BUON. 2021 May-Jun;26(3):656-662.

Abstract

PURPOSE

To compare the efficacy and safety of uterine arterial interventional chemoembolization (UAIC) combined with radiotherapy and intravenous chemotherapy combined with radiotherapy in the treatment of mid-advanced cervical cancer.

METHODS

The clinical data of 128 patients with mid-advanced cervical cancer were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups. Docetaxel+nedaplatin UAIC combined with intensity-modulated radiotherapy was performed in UAIC group (n=64), while docetaxel+nedaplatin intravenous chemotherapy combined with intensity-modulated radiotherapy (IMRT) was performed in the control group (n=64). The short-term clinical efficacy and incidence of adverse reactions were compared between the two groups. The tumor recurrence and survival status were recorded during follow-up, and the progression-free survival (PFS) and overall survival (OS) were compared between the two groups.

RESULTS

The short-term clinical response rate was 70.3% (45/64) and 48.4% (31/64), respectively, in the UAIC and the control group. In the functional scales of European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30), the scores of physical function, role function, cognitive function, emotional function and social function were higher in the UAIC group than in the control group, but only the emotional function score had a statistically significant difference. In the symptom scales, the scores of sleep disturbance, nausea and vomiting, pain and fatigue were obviously lower in the UAIC group than those in the control group. The general health score was 79.46±11.28 points and 78.17±13.49 points, respectively, in the UAIC and the control group. Follow-up results revealed that the 3-year OS was 70.3% (45/64) and 73.4% (47/64), and the 3-year PFS was 64.1% (41/64) and 65.6% (42/64), respectively, in the UAIC and the control group. Log-rank test showed that OS and PFS had no statistically significant differences between the two groups.

CONCLUSIONS

UAIC combined with radiotherapy has better short-term clinical efficacy than intravenous chemotherapy combined with radiotherapy in the treatment of mid-advanced cervical cancer, with fewer adverse reactions and higher quality of life, but it had no significant effect on the long-term survival and tumor progression.

摘要

目的

比较子宫动脉介入化疗栓塞术(UAIC)联合放疗与静脉化疗联合放疗治疗中晚期宫颈癌的疗效和安全性。

方法

回顾性分析 128 例中晚期宫颈癌患者的临床资料。根据不同的治疗方法,将患者分为两组。UAIC 组(n=64)行多西他赛+奈达铂 UAIC 联合调强放疗,对照组(n=64)行多西他赛+奈达铂静脉化疗联合调强放疗。比较两组患者的近期临床疗效和不良反应发生率。随访记录肿瘤复发和生存情况,比较两组患者的无进展生存期(PFS)和总生存期(OS)。

结果

UAIC 组和对照组的近期临床缓解率分别为 70.3%(45/64)和 48.4%(31/64)。欧洲癌症研究与治疗组织生命质量核心问卷 30 项(EORTC-QLQ-C30)功能量表中,生理功能、角色功能、认知功能、情绪功能和社会功能评分 UAIC 组均高于对照组,但仅情绪功能评分差异有统计学意义。症状量表中,睡眠障碍、恶心呕吐、疼痛和疲劳评分 UAIC 组均明显低于对照组。一般健康状况评分 UAIC 组为 79.46±11.28 分,对照组为 78.17±13.49 分。随访结果显示,UAIC 组和对照组的 3 年 OS 分别为 70.3%(45/64)和 73.4%(47/64),3 年 PFS 分别为 64.1%(41/64)和 65.6%(42/64)。Log-rank 检验显示,两组患者的 OS 和 PFS 差异均无统计学意义。

结论

UAIC 联合放疗治疗中晚期宫颈癌的近期临床疗效优于静脉化疗联合放疗,不良反应少,生活质量高,但对长期生存和肿瘤进展无显著影响。

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