80例局部宫颈癌根治性同步放化疗的临床疗效及预后影响因素

来源期刊：广州医药 | 1350-1356 发布时间：2024-12-02 收稿时间：2025/11/13 18:43:40 阅读量：51

作者：: 李春蕾,

郭凤枝,

郭玉生,

郭改梅,

郭洁,

关键词：: 宫颈癌同步放化疗预后影响因素生存率不良反应回归分析; cervical cancer synchronous radiotherapy and chemotherapy prognostic influencing factors survival rate adverse reactions regression analysis

DOI：: 10.20223/j.cnki.1000-8535.2024.11.018

收稿时间：: 2024-02-04
修订日期：
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引用总数：: 0

目的探讨80例局部宫颈癌根治性同步放化疗的临床疗效及预后影响因素。方法选取鹤壁市妇幼保健院2018年1月—2021年1月收治的80例宫颈癌患者进行回顾性分析,患者依照其病变程度均采取积极的手术与同步放化疗,其中40例患者采取单纯化疗,将其分为化疗组,40例患者采取同步放化疗,将其分为同步放化疗组,分析其近远期临床疗效与不良反应发生率。对所有患者进行3年随访,将患者分为两个亚组,即预后不良组（n=20）和预后良好组（n=60）,对比两组患者一般临床特征,应用Logistic回归模型分析局部宫颈癌根治性同步放化疗的预后影响因素。结果同步放化疗组ORR、DCR高与化疗组（P<0.05）,对照组中位无进展生存期为5.4（2.38~14.52）个月。观察组中位无进展生存期为6.66（2~20.1）个月,观察组高于对照组（χ²=4.536,P=0.041）;同步放化疗组盆腔积液、阴道炎症、泌尿生殖道反应、直肠反应、骨髓抑制、胃肠道反应发生率略高于化疗组,但两组对比差异无统计学意义（P>0.05）;预后良好组与预后不良组患者年龄、是否绝经、病理类型、肿瘤大小对比差异无统计学意义（P>0.05）,预后良好组与预后不良组患者临床分期、组织分化程度、淋巴结转移、是否同步放化疗、治疗前血红蛋白水平对比差异有统计学意义（P<0.05）;组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为局部宫颈癌的预后不良影响因素（P<0.05）。结论对局部宫颈癌患者采取根治性同步放化疗与单一化疗相比可提升其临床疗效与远期生存率,同时安全性较高。组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为宫颈癌预后不良影响因素。

Objective To explore the clinical efficacy and prognostic factors of 80 cases of local cervical cancer treated with radical synchronous radiotherapy and chemotherapy．Methods A retrospective analysis was conducted on 80 cervical cancer patients admitted to Hebi Maternal and Child Health Hospital from January 2018 to January 2021．Patients underwent surgery and synchronous radiotherapy and chemotherapy according to their degree of lesion．Among them,40 patients received simple chemotherapy and were divided into a chemotherapy group,while 40 patients received synchronous radiotherapy and chemotherapy and were divided into a synchronous radiotherapy and chemotherapy group．The short-term and long-term clinical efficacy and incidence of adverse reactions were analyzed．A 3-year follow-up was conducted on all patients,and patients were divided into two subgroups,namely the poor prognosis group（n=20）and the good prognosis group（n=60）．The general clinical characteristics of the two groups of patients were compared,and a Logistic regression model was used to analyze the prognostic factors of local cervical cancer radical synchronous radiotherapy and chemotherapy．Results The objective relief rate and disease control rate of the synchronous radiotherapy and chemotherapy group were significantly higher than those of the chemotherapy group（P<0.05）,and the median progression free survival of the control group was 5.4（2.38-14.52）months．The median progression free survival of the observation group was 6.66（2-20.1）months,which was higher than that of the control group（χ²=4.536,P=0.041）．The incidence of pelvic fluid accumulation,vaginitis,urogenital reactions,rectal reactions,bone marrow suppression,and gastrointestinal reactions in the synchronous radiotherapy and chemotherapy group was slightly higher than that in the chemotherapy group,but there was no statistically significant difference between the two groups（P>0.05）．There was no statistically significant difference in age,menopause,pathological type,and tumor size between the patients with good prognosis and those with poor prognosis（P>0.05）．However,there was a statistically significant difference in clinical stage,tissue differentiation,lymph node metastasis,synchronous radiotherapy and chemotherapy,and pre-treatment hemoglobin levels between the patients with good prognosis and those with poor prognosis（P<0.05）．Low degree of tissue differentiation,lack of synchronous radiotherapy and chemotherapy,and low hemoglobin levels before treatment were adverse prognostic factors for local cervical cancer（P<0.05）．Conclusion sCompared with single radiotherapy,radical synchronous radiotherapy and chemotherapy can improve the clinical efficacy and long-term survival rate of patients with local cervical cancer,with higher safety．The severe tissue differentiation,unsynchronized chemoradiotherapy and hemoglobin before treatment were the adverse prognostic factors of cervical cancer．

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