摘要
目的探讨新疆地区ⅠB~ⅡA期宫颈癌不同治疗模式的疗效及并发症。方法回顾性分析本院215例ⅠB~ⅡA期宫颈癌患者的临床病理资料并随访其生存情况,分析总体及不同临床病理参数的5年生存率,采用Cox模型分析影响预后的独立因素;根据治疗方案将215例患者分为根治性手术（81例）、根治性放疗（65例）、术前辅助治疗（25例）及术后辅助治疗（44例）,分析各种治疗模式的预后及并发症情况。结果总体5年生存率为79.3%。不同FIGO分期、族别、肿瘤直径、分化程度及术后病理高危因素的5年生存率差异均有统计学意义（P〈0.05）;Cox模型分析显示,FIGO分期、肿瘤直径及术后病理高危因素是宫颈癌预后的独立危险因素（P〈0.05）。根治性手术、根治性放疗、术前辅助治疗及术后辅助治疗者的5年生存率依次为80.9%、82.5%、78.8%和72.4%,并发症发生率依次为25.9%、18.5%、24.0%和38.6%,差异均无统计学意义（P〉0.05）。结论对术后有危险因素或术前肿瘤体积较大患者行相应辅助治疗可达到无危险因素患者根治性手术或根治性放疗的治疗效果,故建议临床工作中对不同患者施行个体化治疗,在保证治疗效果的前提下尽量减少并发症及患者治疗负担。
Objective To compare the outcomes and incidences of complication in Ⅰ B- Ⅱ A cervix cancer with different treat- merit in Xinjiang. Methods In a retrospective study, the clinical and pathological data of 215 patients with Ⅰ B- Ⅱ A cervical cancer were collected as well as follow-up data. The overall 5-year survival rate was investigated and the stratification analysis of 5-year survival rate was made by clinicopathologieal parameters. Cox model was used to analyze the independent prognostic factors. According to treat- ment regimens, 215 patients were assigned into 4 groups ： radical operation （ n = 81 ）, radical radiotherapy （ n = 65 ） , preoperative adju- vant therapy （n = 25 ） and postoperative adjuvant therapy （n = 44）. The prognosis and complications were analyzed among 4 groups. Results The overall 5-year survival rate was 79.3%, and varied among different FIGO stages, nations,tumor sizes, degrees of differ- entiation and postoperative risk factor （P〈0.05）. Cox model showed that clinical stage, tumor size, degrees of differentiation and post- operative risk factor were independent prognostic factors for cervical cancer （ P 〈 0.05 ）. The 5-year survival rates were 80. 9%, 82.5%, 78.8% and 72.4% and the incidence rates of complication were 25.9%, 18.5%, 24.0% and 38.6% for patients receiving radical operation, radical radiotherapy, preoperative adjuvant therapy or postoperative adjuvant therapy with no significant differences （ P〉0. 05）. Conclusion For patients with postoperative risk factors and preoperative large tumor volume, the corresponding postoper- ative adjuvant therapy can achieve similar effect as radical operation or radical radiotherapy for patients without risk factors. The indi- vidual treatment was recommended for different patients in the clinical work. In the premise of ensuring the therapeutic effect, every possible effort should be made to reduce complications of patients.
出处
《临床肿瘤学杂志》
CAS
2015年第3期244-248,共5页
Chinese Clinical Oncology
基金
乌鲁木齐市感染与肿瘤重点实验室基金资助项目(H111313001)
乌鲁木齐市感染与肿瘤重点实验室(培育基地)开放课题项目(WIT-2013-01)
关键词
宫颈癌
治疗模式
预后
并发症
Cervix cancer
Treatment model
Prognostic
Complication
