摘要
[目的]评价宫颈癌手术或放射治疗后阴道复发再治疗的疗效。[方法]回顾性分析1972年7月￣1992年7月在复旦大学肿瘤医院收治的193例手术或放疗后阴道复发的宫颈癌,采用以再放疗为主同时辅以化疗的治疗方法。[结果]2年、3年和5年生存率,手术后复发组分别为65.8%、56.9%和44.1%;放疗后复发组分别为50.0%、40.6%和30.2%,两组有显著差异(P<0.05)。肿瘤<4cm和≥4cm的局部控制率手术后复发组分别为89.1%和76.0%(P>0.05);放疗后复发组为80.0%和25.0%(P<0.01)。再放疗的放射并发症:放疗后复发组放射性膀胱炎、直肠中、重度反应的发生率分别为13.1%、15.7%和14.9%,高于手术后复发组。放疗后近期与远期复发再放疗的局部控制率及5年生存率均有非常显著差异(P<0.01)。[结论]宫颈癌治疗后阴道复发的再放疗是有价值的。应采用个体化的治疗原则以尽量减轻放射并发症。
[Purpose] To assess the treatment effect for vaginal recurrence following initial surgical or radiation therapy for cervical cancer. [Methods] One hundred and ninety-three cases of cervical cancer with vaginal recurrence after initial surgical or radiation therapy in Cancer Hospital, Fudan University from Jul. 1972 to Jul. 1992 were retrospectively analyzed. Reradiation-based concurrent chemotherapy were carried out. [Results] The 2-, 3-, 5-year survival rate in recurrence after operation was 65.8%,56.9% and 44.1%; and in recurrence after radiation was 50.0%, 40.6% and 30.2% respectively, with significant difference between the two groups （P〈0.05）. The local control rate in tumor volume 〈4cm and ≥4cm was 89.1% and 76.0% respectively in the group of recurrence after operation （P〉0.05）; and in the group of recurrence after radiation, was 80.0% and 25.0% respectively （P〈 0.01）. The radiation complications were higher in group with initial radiation than that initial with surgery. The rate of radiation cystitis （hematuria）, middle and serious rectal radiotoxicity in group with initial radiation was 13.1%, 15.7% and 14.9%, respectively. There was significant difference in local control and 5-year survival rate of re-radiation for early and late recurrence in group with initial radiation. （P〈0.01）. [Conclusion ] It is valuable to radiation again for cervical cancer with vaginal recurrence. Individualized treatment should be carried out to alleviate the radiation complications.
出处
《肿瘤学杂志》
CAS
2006年第5期363-365,共3页
Journal of Chinese Oncology
关键词
宫颈肿瘤
阴道复发
治疗
放射疗法
cervical neoplasms
vaginal recurrence
treatment
radiotherapy
