| 修雨婷,孟凡旭,欧健,王琢,杜晶,赵康康,王蕴龙,陈志深,田琦,孙宝胜.211例宫颈癌根治性放疗的预后分析[J].中华放射医学与防护杂志,2019,39(10):762-767 |
| 211例宫颈癌根治性放疗的预后分析 |
| Prognostic analysis of radical radiotherapy for 211 cases of cervical cancer |
| 投稿时间：2019-06-11 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.10.009 |
| 中文关键词: 宫颈癌 根治性放疗 疗效 预后 |
| 英文关键词:Cervical cancer Radical radiotherapy Efficacy Prognosis |
| 基金项目:安徽省公益性技术应用研究联动计划项目（1704f0804051）；安徽省重点研究与开发计划项目（1804h08020279）；安徽省自然科学基金项目（1708085QC80） |
| 作者 | 单位 | E-mail | | 修雨婷 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 孟凡旭 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 欧健 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 王琢 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 杜晶 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 赵康康 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 王蕴龙 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 陈志深 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 田琦 | 吉林省肿瘤医院放疗科, 长春 130021 | | | 孙宝胜 | 吉林省肿瘤医院放疗科, 长春 130021 | xiuyuxiong@163.com |
|
| 摘要点击次数: 2527 |
| 全文下载次数: 1226 |
| 中文摘要: |
| 目的 探讨宫颈癌根治性放疗疗效以及影响预后的因素。方法 回顾性分析2014年6月至2017年2月于吉林省肿瘤医院放疗四科治疗的宫颈癌ⅠA-ⅢB期患者共211例的临床资料，所有患者均行根治性放疗伴或不伴同步化疗。观察近、远期疗效和相关预后因素，生存分析采用Kaplan-Meier法，单因素分析采用Log-rank检验进行，多因素分析采用COX比例风险回归模型进行。结果 2年总生存率（OS）、无病生存率（DFS）分别为83.4%、72.5%。随访期间死亡46例（21.8%），其中，2例非肿瘤相关死亡，1例第二原发肿瘤结肠癌导致死亡；复发转移57例（27%），其中单纯局部复发16例（28.1%），单纯远处转移27例（47.4%），局部复发合并远处转移14例（24.6%）。单因素分析显示，2年OS、DFS与病理类型、治疗前鳞状细胞抗原（SCC）水平及分期明显相关（OS：χ2=7.123、6.014、8.398，P<0.05；DFS：χ2=11.832、8.003、7.731，P<0.05），除以上因素外，2年DFS还与盆腔淋巴结转移有关（χ2=9.286，P<0.05）；多因素分析显示，病理类型、治疗前SCC值、分期是影响OS的独立预后因素（HR=2.963、2.473、2.574，P< 0.05），影响DFS的独立预后因素则包括病理类型、治疗前SCC值及盆腔淋巴结转移（HR=3.014、1.988、1.914，P< 0.05）。结论 宫颈癌根治性放疗的患者中，腺癌、中晚期、放疗前SCC值超过30 ng/ml者预后较差，需采取更加积极的治疗策略。 |
| 英文摘要: |
| Objective To investigate the curative effect and prognostic factors of radical radiotherapy for cervical cancer. Methods A total of 211 patients with stage ⅠA-ⅢB cervical cancer who underwent therapy in department of radiotherapy, Tumor Hospital of Jilin province between June 2014 and February 2017, were analyzed retrospectively. All patients received radical radiotherapy with or without concurrent chemotherapy. Short-term and long-term efficacy and related prognostic factors were observed. Kaplan-Meier method was used for survival analysis, Log-rank test was used for univariate analysis, and Cox proportional hazards regression model was used for multivariate analysis. Results The 2-year overall survival (OS) and disease free survival (DFS) were 83.4% and 72.5%, respectively. During the follow-up periods, 46 patients (21.8%) died, including two from non-tumor-related diseases, and one from second primary colon cancer. Totally 57 patients (27%) had recurrence and metastasis, including 16 (28.1%) with local recurrence, 27 (47.4%) with distant metastasis, and 14 with local recurrence and distant metastasis(24.6%). Univariate analysis showed that 2-year OS and DFS were significantly correlated with pathological type, pre-treatment squamous cell carcinoma antigen (SCC) value and FIGO stage (OS:χ2=7.123, 6.014, 8.398, P<0.05; DFS:χ2=11.832, 8.003, 7.731, P<0.05). In addition to the above factors, 2-year DFS was also associated with pelvic lymph node metastasis (χ2=9.286, P<0.05). Multivariate analysis showed that pathological type, pre-treatment SCC value and FIGO stage were independent prognostic factors of OS(HR=2.963, 2.473, 2.574, P<0.05). The independent prognosis factors affecting DFS included pathological type, pre-treatment SCC value and pelvic lymph node metastasis (HR =3.014, 1.988, 1.914, P<0.05). Conclusions By means of radical radiotherapy, cervical cancer patients with adenocarcinoma, pre-treatment SCC levels ≥ 30 ng/ml and advanced stage have poor prognosis, so more active treatment strategy should be adopted. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|