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[子宫颈III期癌。92例患者的诊断、治疗及预后(作者译)]

[Stage III cancer of the cervix. The diagnosis, treatment and prognosis in a series of 92 patients (author's transl)].

作者信息

Heintz J

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1980;9(6):695-704.

PMID:7462574
Abstract

This study is of 92 patients who were treated for Stage III carcinoma of the cervix in the Henri Becquerel Centre. We have ruled out the 11 patients who refused to complete their treatment or who died before treatment started. The average age was 63 years. The Stage III cases were divided into 40 Stage III A and 41 Stage III B, with 10 who had urinary tract involvement. These were epidermoid carcinomata. The treatment was by external radiotherapy followed by superimposed radium therapy in 66 cases. 15 patients were treated by external radiotherapy alone. The lumboartic nodes were treated in the area that was irradiated in 5 patients. The actuarial figures for survival work out at 51 per cent at 5 years for Stage III A cases and 34 per cent for Stage III B cases. Pelvic recurrences were responsible for 87 per cent of the failures. In fact, in almost 87 per cent of the cases the area was not completely sterilised. The percentage of failures was higher in the group that had altered lymphograms. The prognosis was worst when the upper urinary tract was affected. All patients who had positive lymphograms or those that were suspicious of having lumboaortic nodes involved died. In the 15 patients who did not have added radium therapy there were 13 cases who were not sterilised and 1 that recurred at 13 months. In 32 per cent of cases the failures in the pelvis were associated with pathology in distant lymph nodes and/or with visceral metastases. We found 13 per cent of solitary metastases. Between 5 and 10 years the failure rate is 9 per cent with a level of 6.3 per cent of pelvic recurrences associated or not associated with metastases or even with complications. Our patients had 8 rectosigmoid complications of which 2 needed a diversion colostomy. There were 7 cases of cystitis after X-ray, in the majority of a benign nature, and 2 bony complications that recovered spontaneously. After a study of the diagnosis and treatment of Stage III cancer of the cervix, the discussion compares the results found in this study with those to be found in the literature.

摘要

本研究涉及92例在亨利·贝克勒尔中心接受治疗的III期宫颈癌患者。我们排除了11例拒绝完成治疗或在治疗开始前死亡的患者。平均年龄为63岁。III期病例分为40例III A期和41例III B期,其中10例有尿路受累。这些均为表皮样癌。66例患者采用体外放疗后叠加镭疗。15例患者仅接受体外放疗。5例患者对腰动脉淋巴结进行了照射区域的治疗。III A期病例5年的精算生存率为51%,III B期病例为34%。盆腔复发导致了87%的治疗失败。事实上,几乎87%的病例该区域未完全消除肿瘤。淋巴造影改变的组中失败率更高。当上尿路受累时预后最差。所有淋巴造影阳性或怀疑腰主动脉淋巴结受累的患者均死亡。在15例未接受额外镭疗的患者中,有13例未消除肿瘤,1例在13个月时复发。32%的盆腔治疗失败与远处淋巴结病变和/或内脏转移有关。我们发现了13%的孤立转移。在5至10年之间,失败率为9%,盆腔复发率为6.3%,与转移或并发症有关或无关。我们的患者有8例乙状结肠直肠并发症,其中2例需要行结肠造口术改道。放疗后有7例膀胱炎,大多数为良性,2例骨并发症自行恢复。在对III期宫颈癌的诊断和治疗进行研究后,讨论将本研究的结果与文献中的结果进行了比较。

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