邵琳++++++原银萍++++++孙妮娜++++++李大鹏

[摘要] 目的 探讨三维适形放疗联合同步化疗对复发性宫颈癌的疗效。方法 选取2009年2月～2011年4月山东省肿瘤医院妇科收治的复发性宫颈癌患者82例，按照随机数字表法分为观察组和对照组，观察组42例，给予三维适形放疗联合同步化疗；对照组40例，给予常规放疗方法治疗。对比分析两组患者治疗效果。结果 观察组患者治疗3个月后、12个月后，总有效率明显优于对照组患者，差异均有高度统计学意义（P < 0.01）；观察组生存时间5.2～25.3个月，中位生存时间10.2个月，36个月生存率为23.8%；对照组生存时间3.6～23.5个月，中位生存时间8.6个月，36个月总生存率为7.5%，根据生存曲线分析，观察组明显优于对照组（P < 0.05）。观察组有18例出现不良反应，对照组有33例出现不良反应，两组患者不良反应比较，差异有统计学意义（P < 0.05）。 结论 复发性宫颈癌患者采用三维适形放疗联合同步化疗治疗，可改善患者近期疗效及生存率，同时明显减少不良反应发生率，使患者生存质量和预后得到显著改善。

[关键词] 宫颈癌；复发；三维适形放疗；同步化疗；疗效

[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2015）10（b）-0067-04

Effect of three dimensional conformal radiotherapy combined with concurrent chemotherapy for patients with recurrent cervical cancer

SHAO Lin1 YUAN Yinping2 SUN Ni'na1 LI Dapeng3▲

1. Department of Gynecology， Shandong Provincial Communications Hospital， Shandong Province， Ji'nan 250031， China； 2. Department of Pathology， Shandong Tumor Hospital， Shandong Province， Ji'nan 250017， China； 3. Department of Gynecology， Shandong Tumor Hospital， Shandong Province， Ji'nan 250017， China

[Abstract] Objective To investigate the effect of three dimensional conformal radiotherapy combined with synchronous chemotherapy for recurrent cervical cancer. Methods From February 2009 to April 2011， 82 cases with recurrent cervical cancer patients in Department of Gynecology， Shandong Tumor Hospital were divided into the observation group and the control group according to random number table. 42 cases in the observation group received three dimensional conformal radiotherapy combined with concurrent chemotherapy， and 40 cases in the control group were treated with conventional radiotherapy. The effect of the two groups were compared and analyzed. Results The curative effect treated for 3 months and 12 months in the observation group were obviously superior than that in the control group， and the differences were statistically significant （P < 0.01）. The survival time of the observation group was 5.2-25.3 months， median survival time was 10.2 months and survival rate of 36 months was 23.8%； survival time of the control group was 3.6-23.5 months， median survival time was 8.6 months， survival rate of 36 months was 7.5%. According to the survival curve， the observation group was significantly better than that in the control group （P < 0.05）. There were 18 cases of adverse reactions in the observation group， and 33 cases in the control group， the differences were statistically significant （P < 0.05）. Conclusion Patients with recurrent cervical cancer using three dimensional conformal radiotherapy combined with synchronous chemotherapy can increase the clinical efficacy and survival rates， reduce the mortality rate， and improve the quality of survival and prognosis significantly.

[Key words] Cervical cancer recurrence； Three dimensional conformal radiotherapy； Concurrent chemotherapy； Efficacy

复发性宫颈癌患者通常可伴有体重减轻、盆腔疼痛及下肢水肿等临床表现，研究报道[1]，70%左右的患者发病于宫颈癌处置后的24个月之内，仅少数患者可经手术切除治疗。由于患者在复发前具有手术史及放化疗史，导致临床治疗难度大且预后较差，如采用盆腔后野垂直照射则易产生较大不良反应，且可能存在放疗剂量不足等风险[2]，而三维适形放疗与同步化疗联合治疗可有效降低肿瘤正常组织损伤，且有效增加肿瘤局部剂量。故本研究将2009年2月～2011年4月山东省肿瘤医院（以下简称“我院”）妇科收治的82例复发性宫颈癌患者作为研究对象，对其采用三维适形放疗与同步化疗联合治疗的近期疗效及预后进行了探讨，现报道如下：

1 资料与方法

1.1 一般资料

选取2009年2月～2011年4月我院妇科收治的复发性宫颈癌患者82例。按照随机数字表法分为观察组和对照组，观察组42例，给予三维适形放疗联合同步化疗；……