摘要
目的分析阿帕替尼联合放化疗治疗复发伴转移宫颈癌患者的近期疗效及预后影响因素。方法选取2011年10月至2016年10月收治的98例宫颈癌术后出现复发转移的女性患者作为研究对象,进行回顾性研究。根据所实施的治疗方案分为联合组及对照组各49例,对照组采用常规化疗和放疗治疗,联合组在对照组基础上采用阿帕替尼联合治疗。比较两组患者近期疗效、毒副反应,同时采用单因素分析和多因素Cox回归分析复发伴转移宫颈癌患者预后的相关因素。结果疗程结束后1个月评价,联合组患者治疗后临床总有效率(93.88%)明显高于对照组(77.55%,P<0.05);两组患者在治疗过程中均出现肝功能损伤、消化道反应、放射性膀胱炎、放射性直肠炎以及骨髓抑制,但两组毒副反应发生率比较差异无统计学意义(P均>0.05);所有宫颈癌术后复发伴转移患者的随访时间为2~36个月,3年总生存率为53.06%(52/98),其中对照组患者3年生存率为44.90%(22/49),联合组患者3年生存率为61.22%(30/49)。经单因素分析得出,肿瘤直径、淋巴转移数、脉管内肿瘤以及临床分期与复发伴转移宫颈癌患者预后相关(P<0.05,P<0.01);经多因素逐步Cox比例风险回归分析得出,联合治疗方式是复发伴转移宫颈癌患者预后良好的促进因素(P<0.01);临床Ⅳ期、淋巴转移>3个及出现脉管内肿瘤均为复发伴转移宫颈癌患者预后的独立危险因素(P<0.05,P<0.01)。结论阿帕替尼联合放化疗治疗复发伴转移宫颈癌患者的近期疗效有明显提高。复发伴转移宫颈癌患者预后与淋巴转移数、脉管内肿瘤以及临床分期存在密切关系,因此治疗过程中需注意以上影响预后的因素。
Objective To investigate the short-term efficacy and prognostic factors of apatinib combined with chemo-radiotherapy in the treatment of recurrent cervical cancer with metastasis.Methods A total of 98 patients with postoperative recurrence and metastasis of cervical cancer who received treatment from October 2011 to October 2016 were selected as study objects.The clinical data of patients were analyzed retrospectively.According to the treatment plan,they were divided into combination group and control group(n=49,each).The control group patients received conventional chemotherapy and radiotherapy,and the combined group patients received apatinib in combination on the basis of the control group.The short-term efficacy and side effects were compared between the two groups.Univariate analysis and multivariate Cox regression analysis were used to analyze the prognostic factors of recurrent cervical cancer patients with metastasis.Results One month after the end of treatment,the evaluation was conducted.The clinical total effective rate of the combined group was significantly higher than that of the control group(93.88% vs 77.55%,P<0.05).Liver function injury,gastrointestinal reaction,radiation cystitis,radiation proctitis and bone marrow suppression occurred in both groups,but there was no significant difference between the two groups(all P>0.05).The follow-up time of all patients was 2-36 months.The 3-year survival rate of all patients was 53.06%(52/98).The 3-year survival rate of the control group was 44.90%(22/49) and that of the combination group was 61.22%(30/49).Univariate analysis showed that tumor diameter,number of lymph node metastasis,intravascular tumor and clinical stage were related to the prognosis of patients with recurrent and metastatic cervical cancer(P<0.05,P<0.01).Multivarate stepwise Cox proportional hazard regression analysis showed that combination therapy was a good prognostic factor for patients with recurrent and metastatic cervical cancer(P<0.05).Clinical stage IV,number of lymphatic metastasis >3 and presence of intrarascular tumor were independent risk factors for the prognosis of patients with recurrent and metastatic cervical cancer(P<0.05,P<0.01).Conclusions In the treatment of recurrent cervical cancer with metastasis,apatinib combined with chemo-radiotherapy could improve the short-term efficacy of patients.The prognosis of patients with recurrent and metastatic cervical cancer may be closely related to the number of lymphatic metastasis,intravascular tumor and clinical stage,so the above factors should be paid attention to in the treatment.
作者
付玉
齐亮
严丽梅
FU Yu;QI Liang;YAN Li-mei(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Sfiengyang,Liaoning 110004,China)
出处
《中国临床研究》
CAS
2020年第10期1396-1399,共4页
Chinese Journal of Clinical Research
关键词
阿帕替尼
放疗
化疗
复发伴转移
宫颈癌
近期疗效
预后
Apatinib
Radiotherapy
Chemotherapy
Recurrent with metastasis
Cervical cancer
Short-term efficacy
Prognosis
