摘要
目的 通过对 15 7例ⅠB～ⅡB期宫颈癌术前放化疗患者进行分析 ,探讨术前不同治疗方法与手术疗效的关系。方法 分别对 76例及 81例ⅠB～ⅡB期患者行术前介入化疗及腔内放疗 ,化疗组术前采用选择性髂内动脉插管化疗 ,药物 :顺铂80～ 10 0mg、表阿霉素 70mg、5 氟脲嘧啶 1～ 1.2 5 g。放疗组术前采用192 Ir高剂量率腔内放疗 ,A点剂量 10 0 0～ 2 0 0 0cGy/2～4次共 1～ 2周 ,治疗后 2周左右行宫颈癌根治术。结果 术前介入化疗后肿瘤退缩率好于术前放疗者 ;术后病理高危因素发生率亦低于术前放疗者 ,但均无显著性差异 (P >0 .0 5 )。在巨块型宫颈癌患者 (肿瘤直径≥ 4cm)中 ,化疗组及放疗组术后 2年复发率分别为 12 .5 %及 31.9% (P <0 .0 5 ) ,而当宫颈肿瘤直径 <4cm时 ,放疗组及化疗组术后 2年复发率无明显差异 (P >0 .0 5 )。术前治疗有效者及无效者术后 2年复发率分别为 13.6 %及 30 .3% (P <0 .0 5 )。结论 巨块型宫颈癌患者术前行介入化疗者预后好于术前放疗者 ;术前治疗后肿瘤退缩情况与术后 2年复发率相关。
Objective To evaluate the preoperative intraarterial chemotherapy and intracavity brachytherapy radiotherapy in stage ⅠB ～ⅡB cervical cancer patients and investigate the factors that affect the prognosis of radical hysterectomy in different preoperative treatment. Methods 76 patients were treated by intraarterial chemotherapy followed by radical hysterectomy. The chemotherapy drugs were cisplatin (DDP) 80～100mg, epirubincin (E ADM) 70mg and fluorouracil (5 FU) 1 1.25g which was injected into the internal iliac artery by catheter, once per 3 weeks,for 2 courses. 81 patients were treated with high dose rate intracavitary brachytherapy radiotherapy followed by radical hysterectomy. The A point dose was 1000～2000cGy/2～4 times /1～2w. Results The tumor regression of the chemotherapy was better than that of the radiotherapy, but without statistic significance. The pathological risk factors were fewer in the patients treated with chemotherapy, but no statistic significance too. The 2 year recurrent rate was 12.5% and 31.9% in bulk tumor(≥4cm) patients treated with chemotherapy and with radiotherapy respectively ( P <0.05). The 2 year recurrent rate was 13.6% and 30.3% in patients who responded to the preoperative treatment and those patients did no response respectively ( P <0.05). Conclusion The prognosis of the patients with bulky tumors treated with chemotherapy followed by radical hysterectomy is better than that of radiotherapy followed by radical hysterectomy. The tumor regression after preoperative treatment affects the 2 year recurrent rate.
出处
《肿瘤》
CAS
CSCD
北大核心
2002年第3期220-222,共3页
Tumor
关键词
介入化疗
放疗
宫颈癌
手术前
放射疗法
Cervical carcinoma
Intraarterial chemotherapy
Radiotherapy
Operative
Prognosis
