摘要
目的 评估手术切除淋巴结对ⅢC1r期宫颈癌患者预后和生活质量的影响。方法 回顾性分析2018—2023年本院收治的142例ⅢC1r期宫颈癌患者的临床资料和生活质量问卷(EORTC QLQ-CX24),根据治疗方案分为两组,将行广泛性子宫切除术+盆腔淋巴结清扫术±腹主动脉旁淋巴结清扫术±术后辅助放疗/化疗定义为手术组(PL组,80例),接受规范的铂类化疗药物为基础的辅助化疗6~8个疗程辅以局部放射性治疗为同步放化疗组(CCRT组,62例)。比较两组患者的无病生存时间(DFS)及生活质量问题,探讨手术切除盆腔淋巴结对ⅢC1r期宫颈癌患者生存疗效的影响。结果 通过比较两组的DFS和生活质量评分,发现PL组的中位DFS为53个月,CCRT组为42个月,差异具有统计学意义(P=0.037)。肿瘤特征如直径、组织学类型、宫颈受累程度等与DFS缩短相关。在EORTC QLQ-CX24问卷中,两组患者在性忧虑和身体形象维度得分较高,分别为(36.93±3.93)分和(38.55±3.04)分,两组间差异具有统计学意义(P=0.008),且PL组生活质量更优(P<0.05)。结论 对于ⅢC1r期宫颈癌患者,手术切除淋巴结的PL组在DFS和生活质量方面表现优于CCRT组,提示PL切除术为有效治疗选择。
Objective To evaluate the effects of surgical lymph node resection on prognosis and quality of life in patients with stage ⅢC1r cervical cancer.Methods A retrospective analysis was conducted on the clinical data and quality of life questionnaire(EORTC QLQ-CX24) of 142 patients with stage ⅢC1r cervical cancer who were treated at our hospital between 2018 and 2023.Based on treatment strategy,patients were divided into two groups:the surgery group(PL group,n=80),which underwent radical hysterectomy with pelvic lymphadenectomy±para-aortic lymphadenectomy±adjuvant radiotherapy/chemotherapy,and the concurrent chemo-radiotherapy group(CCRT group,n=62),which received standard platinum-based chemotherapy(6~8 cycles) combined with local radiotherapy.Disease-free survival(DFS) and QoL(assessed via the EORTC QLQ-CX24 questionnaire) were compared between the two groups to evaluate the impact of surgical lymph node resection on survival outcomes.Results The median DFS in the PL group was 53 months,and that in the CCRT group was 42 months,the difference between the two groups was statistically significant(P=0.037).Tumor characteristics such as size,histologic type,and cervical involvement were associated with reduced DFS.In the EORTC QLQ-CX24 assessment,both groups exhibited high scores in sexual worry(36.93±3.93) and body image(38.55±3.04),with statistically significant differences between groups(P=0.008).The PL group demonstrated superior overall QoL(P<0.05).Conclusions For patients with stage ⅢC1r cervical cancer,the PL group received surgical lymph node resection was superior to the CCRT group in DFS and QoL,suggesting that PL resection may be an effective treatment option.
作者
李伯涓
汤淳熙
陈智健
帅之燕
牟大英
刘晓云
Li Bojuan;Tang Chunxi;Chen Zhijian;Shuai Zhiyan;Mou Daying;Liu Xiaoyun(The Third Affiliated Hospital of Zunyi Medical University(The First People's Hospital of Zunyi),Zunyi,Guizhou 563000,China;Guizhou Maotai Hospital,Renhuai,Guizhou 564599,China)
出处
《齐齐哈尔医学院学报》
2025年第10期952-957,共6页
Journal of Qiqihar Medical University
关键词
ⅢC1r期宫颈癌
盆腔淋巴结转移
无病生存期
生活质量评分
放化疗不良反应
StageⅢC1r cervical cancer
Pelvic lymph node metastasis
Disease-free survival
Quality of life score
Adverse effects of chemo-radiotherapy
