摘要
目的对接受调强放疗的子宫内膜癌淋巴结复发患者的生存率进行分析,并探讨影响生存率的影响因素。方法以2012年9月—2013年10月浙江省人民医院放疗科收治的40例子宫内膜癌淋巴结复发患者为研究对象,全部患者采用调强放疗,以放疗前以及同步放疗时接受化疗方案的不同为分组依据,分析不同化疗方案下FIGO分期、复发部位数量、复发部位、病理分类、分化程度特征差异,Kaplan-Meier法计算全部患者生存率,比较不同化疗方案下患者的生存率差异。结果接受放疗前初始化疗患者14例(35%),放疗时同步化疗22例(55%)。FIGO分期Ⅰ/Ⅱ期21例、Ⅲ/Ⅳ期19例,单处复发15例、多处复发25例,复发部位大小<3 cm 23例、≥3 cm 17例,盆腔复发13例、腹主动脉旁淋巴结复发8例、盆腔+腹主动脉旁淋巴结复发19例,子宫内膜腺癌31例、透明细胞癌3例、腺麟癌3例、浆液性腺癌3例;低分化7例、中分化22例、高分化11例;不同放疗方案下的患者FIGO分期、复发部位、复发部位数量和大小、病理分类、分化程度特征差异无统计学意义(P>0.05)。患者2年总体生存率为72.5%,放疗前化疗患者生存时间较未接受初始化疗的患者短(P=0.043),放疗时同步化疗患者的生存时间更长(P=0.045),差异有统计学意义(P<0.05)。结论调强放疗同步化疗可提高子宫内膜癌淋巴结复发患者远期生存时间,而放疗前化疗不利于生存率的改善。
Objective To analyze the result of intensity modulated radiation therapy（IMRT） in recurrent endometrial car- cinoma and its influence factors. Methods Fourty cases of patients with endometrial cancer in our hospital from Septem- ber,2012 to October,2013 were treated with IMRT for regionally pelvic or paraortic nodal recurrences. Compare FIGO stage, number of recurrent sites, size of largest recurrent node, lymph node dissection, histology and grade characteristics according to the types of chemotherapy. Survival rate was calculated by Kaplan-Meier method. Results Fourteen （35 % ） initially received chemotherapy and 22 （55 % ） received concurrent chemotherapy. FIGO stage：Ⅰ / Ⅱ of 21 cases, Ⅲ/Ⅳ of 19 cases. Number of reeurrent sites ： 15 cases of single site ,25 cases of multiple sites. Tumor diameter ：23 cases 〈 3 cm diameter, 17 cases1〉3 cm. Lymphatic stromal invasion ：13 cases of pelvic nodal recurrences,8 cases of paraortic recur- rences only, 19 cases of simultaneous pelvic and paraortie recurrences. Pathological ：31 cases of adenocarcinoma, clear-cell carcinoma in 3 cases ,3 cases of adenosquamous carcinoma,3 cases of serous adenocareinoma. Histological grade ：7 cases of poorly differentiated ,22 cases of intermediate differentiated, 11 cases of well-differentiated. No different clinical charac- teristics observed between patients treated with and without chemotherapy （ P 〉 0.05 ）. The 2 year survival rate was 72.5%. Patients undergoing initial chemotherapy prior to IMRT had shorter survival rate（ P = 0. 043 ）. Patients receiving concurrent chemotherapy had significantly longer survival rate （ P = 0. 045 ）. Conclusion Concurrent chemotherapy with IMRT can improve survival time in patients with recurrent endometrial cancer. Initially chemotherapy is not beneficial to survival rate.
出处
《中华全科医学》
2016年第11期1863-1866,共4页
Chinese Journal of General Practice
