同步放化疗中晚期宫颈癌患者预后的影响因素

Effects of concurrent radiochemotherapy on intermediate-stage and advanced cervical cancer and its prognosis predictors

  • 摘要: 目的 探讨同步放化疗中晚期宫颈癌患者预后的影响因素。 方法 回顾性调查南京大学医学院附属鼓楼医院2005-2010年采用单纯同步放化疗治疗的125例宫颈癌患者的临床资料,分析同步放化疗中晚期宫颈癌患者预后的影响因素。 结果 125例平均年龄(46.48±10.86)岁,其中Ⅱb期55例、Ⅲ期47例、Ⅳ期23例;鳞癌110例,腺癌15例。患者3年及5年生存率分别为72.00%和61.60%。单因素分析结果显示生存率与年龄、分化程度、FIGO分期、肿瘤直径及血红蛋白量显著相关(P< 0.05),并且5年生存率与肿瘤组织类型显著相关(P< 0.05)。多因素分析显示,分化程度及FIGO分期(P=0.00)是影响患者3年及5年生存率的独立因素。125例中77例(61.60%)出现放射性肠炎,8例(6.40%)出现放射性膀胱炎,6例(4.80%)出现下肢淋巴结水肿,114例(91.20%)出现不同程度的骨髓抑制症状,125例(100%)出现外阴炎表现,119例(95.2%)出现不同程度消化道症状。单因素分析显示,同步放化疗并发症的发生与年龄、肿瘤的组织类型、分化程度、FIGO分期及血红蛋白量均无显著相关性。 结论 中晚期宫颈癌同步放化疗的预后与患者肿瘤的分化程度、分期有相关性。

     

    Abstract: Objective To explore the clinical curative effect of concurrent radiochemotherapy on intermediate-stage and advanced cervical cancer and factors influencing its prognosis. Methods A retrospective investigation was performed on clinical data about 125 cervical cancer patients who underwent concurrent radiochemotherapy alone from 2005 to 2010 in Nanjing Drum Tower Hospital, and the curative effect of concurrent radiochemotherapy on intermediate-stage and advanced cervical cancer and its influence on prognosis were analyzed. Results The average age of 125 patients was(46.48±10.86) years.Of the 125 cases, there were 55 cases in stage Ⅱ, 47 cases in stageⅢ, and 23 cases in stageⅣ, with 110 cases of squamous cell carcinomas and 15 cases of adenocarcinoma.The three-year and five-year survival rates of patients were 72.00% and 61.60%, respectively.Univariate analysis results showed that the survival rates were significantly related to age, degree of differentiation, FIGO staging, tumor diameter and quantity of hemoglobin(P< 0.05) and moreover, the five-year survival rate was significantly related to histological classification(P< 0.05).Multivariate analysis showed that the degree of differentiation and FIGO staging(P=0.00) were independent prognostic factors that influenced three-year and five-year survival rates of patients.Of the 125 cases, radiation enteritis occurred in 77 cases(61.60%), irradiation cystitis in 8 cases(6.40%), lower limb lymph nodule swelling in 6 cases(4.80%), 114 cases(91.20%) showed different degrees of bone marrow suppression, vulvitis occurred in all cases(100%) and 119 cases(95.2%) showed different degrees of digestive tract symptoms.Univariate analysis indicated that the occurrence of concurrent radiochemotherapy complications had no significant relevance with age, histological classification, differentiation degree, tumor size, FIGO staging and hemoglobin amount. Conclusion The prognosis of intermediate-stage and advanced cervical cancer treated by concurrent radiochemotherapy has relevance with patients' age, histological classification, differentiation degree, tumor size, FIGO staging and hemoglobin amount.

     

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