临床肿瘤学杂志

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新疆地区ⅠB~ⅡA期宫颈癌不同治疗模式的疗效及并发症分析

阿达来提·牙生,胡尔西旦·尼牙孜,张宋安,张 蕾,赵化荣

  

  1. 830054 乌鲁木齐 新疆医科大学第一附属医院肿瘤中心一科
  • 收稿日期:2014-09-06 修回日期:2014-11-07 出版日期:2015-03-31 发布日期:2015-03-31
  • 通讯作者: 赵化荣

Comparative analysis of outcomes and incidences of complication in ⅠB-ⅡA cervix cancer with different treatment in Xinjiang

ADALAITI Yasheng, HUERXIDAN Niyazi,ZHANG Songan, ZHANG Lei, ZHAO Huarong.
  

  1. the First Department of Tumor Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
  • Received:2014-09-06 Revised:2014-11-07 Online:2015-03-31 Published:2015-03-31
  • Contact: ZHAO Huarong

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。

Abstract: Objective To compare the outcomes and incidences of complication inⅠB-ⅡA cervix cancer with different treatment in Xinjiang. Methods In a retrospective study, the clinical and pathological data of 215 patients with ⅠB-ⅡA 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 clinicopathological parameters. Cox model was used to analyze the independent prognostic factors. According to treatment regimens, 215 patients were assigned into 4 groups: radical operation (n=81), radical radiotherapy (n=65), preoperative adjuvant 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 differentiation and postoperative risk factor (P<0.05). Cox model showed that clinical stage, tumor size, degrees of differentiation and postoperative 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 postoperative adjuvant therapy can achieve similar effect as radical operation or radical radiotherapy for patients without risk factors. The individual 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.

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