同步放化疗治疗中晚期宫颈癌
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康艾注射液联合同步放化疗治疗中晚期宫颈癌的临床疗效李国红【期刊名称】《医学综述》【年(卷),期】2015(21)10【摘要】目的:探讨康艾注射液联合同步放化疗( RCT)治疗中晚期宫颈癌的疗效。
方法选择2010年9月至2013年5月铜川矿务局中心医院接诊的中晚期宫颈癌患者86例作为研究对象,按照治疗方法不同将患者分为联合治疗组和RCT组,每组43例。
RCT组患者采用 RCT治疗,联合治疗组患者在RCT组基础上加静脉滴注康艾注射液治疗,治疗持续4周。
治疗结束后据实体瘤评价标准评价患者近期疗效、根据卡氏评分评价患者生活质量,并比较治疗所引起的不良反应发生情况。
结果联合治疗组患者的近期有效率为65.1%,RCT组为41.8%,两组疗效比较差异有统计学意义(Z=12.69,P<0.05),联合治疗组患者生活质量的改善情况显著优于 RCT组(P<0.01),且联合治疗组患者白细胞下降、腹痛及恶心呕吐等发生率均显著低于RCT组( P<0.05)。
结论康艾注射液联合同步RCT治疗中晚期宫颈癌的效果明显,不良反应更小,是治疗中晚期宫颈癌较佳的选择之一。
%Objective To explore the efficacy of Kang′ai injection combined with radiochemotherapy ( RCT) in the treatment for advanced cervical cancer.Methods A total of 86 patients with advanced cervi-cal cancer admitted in Centeral Hospital of Tongchuan Mining Bureau from Sep.2010 to May 2013 were ran-domly divided into RCT group and combined treatment group,with 43 cases in each group.Patients in RCT group were treated with radiochemotherapy,and patients in combinedtreatment grou p received intravenous infusion of Kang′ai injection on the basis of treatment in RCT group.The therapy in both group lasted for 4 weeks.After treatment,the short-term efficacies of the two groups were evaluated according to evaluation cri-teria of solid tumors,and the quality of life was evaluated according to KPS scores,besides,the treatment-induced side effects of the two group were compared.Results Recent effective rate of the combined treat-ment group was 65.1% and that of RCT group was 41.8%,there was statistically significant difference between the two groups(P<0.05),the quality of life of patients in the combined treatment group improved more significantly than RCT group(Z =12.69,P <0.01),and the incidences of side effects,such as decreased white blood cell, abdominalgia, nausea and vomiting,in the combined treatment group were signif-icantly lower than those in RCT group(P<0.05).Conclusion The efficacy of Kang′ai injection combined with RCT in treatment for advanced cervical cancer is obvious,with less side effects,thus it is an ideal option for treating advanced cervical cancer.【总页数】2页(P1873-1874)【作者】李国红【作者单位】铜川矿务局中心医院妇产科,陕西铜川727000【正文语种】中文【中图分类】R737.33【相关文献】1.奈达铂或顺铂联合紫杉醇同步放化疗治疗中晚期宫颈癌的临床疗效观察 [J], 刘平;魏子白;于俊岩;常建兰;田向阳;张宁宁;李璐璐;张蓉;张瑛2.多西他赛联合奈达铂同步放化疗治疗中晚期宫颈癌的临床疗效及毒副反应分析[J], 孙娟娟3.康艾注射液联合同步放化疗治疗中晚期宫颈癌的临床分析 [J], 钟金平;黄晶;丁金泉;吴修洪;余瑛;申昌梅4.盆腔热疗联合同步放化疗治疗中晚期宫颈癌的临床疗效与护理 [J], 张菊平5.康艾注射液联合同步放化疗对中晚期子宫颈癌患者细胞凋亡相关因子及免疫状态的影响 [J], 刘畅因版权原因,仅展示原文概要,查看原文内容请购买。
同步放化疗治疗老年中晚期宫颈癌病人的护理陈 燕摘要:对35例老年宫颈癌病人在同步放化疗治疗过程中出现的心理问题及毒副反应进行有针对性的护理,结果35例病人出现的毒副反应经及时治疗、护理,均予有效纠正,顺利完成了同步放化疗。
认为密切观察病人的心理状态及出现的毒副反应,进行恰当的护理干预能够减轻病人病痛、提高病人的生活质量。
关键词:宫颈癌;放疗;化疗;护理中图分类号:R473.73 文献标识码:C doi:10.3969/j.issn.1674-4748.2012.026.040 文章编号:1674-4748(2012)9B-2456-01 宫颈癌在全球女性肿瘤中的发病率占第3位、死亡率占第4位[1],是老年妇女最常见的恶性生殖器官肿瘤,也是严重威胁妇女健康的一种疾病。
同步放化疗目前已经成为中晚期宫颈癌病人的标准治疗方法,可提高病人的生存率、降低复发率[2,3]。
但是同步放化疗给老年病人带来的心理压力增大,各种毒副反应的程度相应加重,增加了中断治疗的风险,因此,密切观察病人的心理状态及出现的毒副反应,有针对性地采取一定的干预措施非常重要。
2009年5月—2012年3月我科收治了35例行同步放化疗治疗的老年宫颈癌病人,并在治疗期间进行精心护理,现将护理总结如下。
1 临床资料1.1 一般资料 35例老年宫颈癌病人年龄60岁~72岁,平均64岁;病理类型:鳞癌32例,腺癌3例;临床分期:ⅡB期12例,ⅢB期23例。
所有病人的骨髓检查及心、肺、肝、肾功能基本正常,均为首次接受放化疗,既往未行任何抗肿瘤治疗。
1.2 治疗方法1.2.1 化疗方法 化疗采用“TP方案”,即紫杉醇135mg/m2第1天静脉输注配合奈达铂80mg/m2第1天静脉输注,每3周重复1次,共2个~4个周期。
化疗过程中结合止吐、保肝等对症支持治疗。
均采用外周静脉留置针化疗。
1.2.2 放疗方法 体外照射配合腔内后装照射。
体外照射采用常规分割放射治疗技术,15MV-X线盆腔大野前后对穿,野上界在第4腰椎与第五腰椎之间,下界在闭孔下缘,左右界为真骨盆各旁开1.5cm~2.0cm;盆腔大野体外照射剂量为45Gy~50Gy,每次照射剂量为1.8Gy~2Gy,每周5次。
顺铂同步放化疗方案治疗中晚期宫颈癌临床效果【摘要】目的:观察探讨中晚期宫颈癌患者应用顺铂同步放化疗方案治疗的临床效果。
方法:于2021年01月--2022年05月接收118例中晚期宫颈癌患者,按红蓝双色球法设为常规组(n=59)、研究组(n=59),常规组放疗,研究组用顺铂同步放化疗。
对比两组治疗效果。
结果:研究组疾病控制率、客观缓解率高于常规组(P<0.05);研究组静脉栓塞、食欲减退、血尿、腹泻等不良反应与常规组无差异(P>0.05);研究组1年内复发率、病灶转移率低于常规组,存活率高于常规组(P<0.05)。
结论:中晚期宫颈癌患者应用顺铂同步放化疗方案治疗具有显著效果,能够降低复发风险,防治病灶转移,提高患者生存率,并且未增加不良反应,安全性良好。
【关键词】宫颈癌;顺铂;放化疗;不良反应;复发率;存活率宫颈癌与HPV感染、宫颈糜烂、多次孕产等因素有关,尤其是HPV感染,已成为宫颈癌发病的关键[1]。
放疗能够延缓宫颈癌发展,但是长期单一放疗效果差强人意,部分患者放疗后,其病情控制依然欠佳,或复发、或转移。
随着肿瘤医学研究深入,发现同步放化疗协同治疗中晚期宫颈癌患者可以抑制病灶增殖,利于疾病控制、缓解[2]。
现代临床治疗恶性肿瘤患者常用铂类药物,不仅具有良好的稳定性,而且不会产生交叉耐药,安全性相对较高[3]。
故本研究纳入118例中晚期宫颈癌患者进行对照探讨并作如下报道:1资料与方法1.1一般资料2021年01月--2022年05月接收118例中晚期宫颈癌患者,按红蓝双色球法设为常规组(n=59)、研究组(n=59),常规组年龄47-71岁,均龄(59.95±6.55)岁;26例II期、24例III期、9例IV期。
研究组年龄46-70岁,均龄(59.99±6.56)岁;25例II期、25例III期、9例IV期。
两组一般资料无差异(P>0.05)。
入组标准:均通过病检证实;初次放化疗;心肝肾肺功能正常;患者知情同意本研究;躯体功能状态良好。
同步放化疗治疗中晚期宫颈癌
作者:刘少兵,周祖金,陈森,覃瑞萍
【摘要】目的观察化疗联合放疗治疗中晚期宫颈癌的临床疗效和毒副作用。
方法 58例中晚期宫颈癌患者随机分成化放组(29例)及单纯放疗组(29例),化放组采用顺铂25mg/m2 d13,静脉点滴,5Fu 350mg/m2 d15静脉点滴,每4周重复,共3个周期,同时进行根治性放疗,化疗第1天开始进行放射治疗。
用10MVX线体外全盆照射DT38~40Gy,中间铅挡后照射致宫旁剂量DT50~55Gy,第3周开始行192Ir腔内照射,6Gy/次/天/周,A点剂量6Gy,B点剂量5Gy,共6~7次。
单纯放射治疗组仅行单纯放疗,方法同化放组,不行化疗。
结果于放疗结束时两组有效率分别为96.6%及86.2%,差异无显著(P >0.05)。
放疗后3个月时两组的有效率分别为96.6%及65.5%,差异显著(P<0.05)。
放化组3、5年生存率和无瘤生存率分别为79.3%、68.9%、62.1%,高于单放组的62.1%、51.7%、41.4%,差异显著(P<0.05),随访5年,化放组的盆腔复发率为17.2%,低于单放组的31.0%,P<0.05。
化放组有较明显的骨髓抑制和消化道反应,但患者经治疗后均可耐受。
结论化疗联合放疗治疗中晚期宫颈癌可增强疗效,副作用稍增加,但患者能耐受。
【关键词】宫颈癌;同步放化疗;疗效;副作用
Prospective Trial for Concurrent Chemoradiotherapy Treatment in Medium term and Advanced Cervical Carcinoma
Abstract:Objective To investigate the clinical curative effects and side effects of chemoradiotherapy for medium term and advanced cervical carcinoma. Methods Fifty eight patients of medium term and advanced cervical carcinoma were randomly divided into two groups: chemoradiotherapy groups and only radiotherapy group. Each patients of the chemoradiotherapy group was given cisplatin at the dose of 25 mg/m2 ivgtt d1 3 ,5Fluorouracil,350mg/m2 ivgtt,d15, repeat every 28 days, total 3 cycles. And radiotherapy was give at the same time, 10 MVX ray was used for external radiation with a total dose of 38~40 Gy;then the middle field is shielded by plumbum, continuous radiotherapy to total dose of 50~55 Gy; 192Ir high dose rate after loading unit was used for branchytherapy after 3 weeks of external radiotherapy at the dose in A point of 6 Gy per time for total 6~7 times. The patients of radiotherapy group were only received radiotherapy with the same dose and same methods. Results The effect rates of the chemoradiotherapy group and
radiotherapy group were 96.6% and 86.2% respectively at the end of the radiotherapy with no difference significantly (P>0.05); Three months after radiotherapy the effect rates in both groups were 96.6% and 65.5%,showing a significant difference (P<0.05). The overall 3year,5year survival rates for the patients in chemoradiotherapy group and radiotherapy group were 79.3%,68.9% and 62.1%,51.7% respectively,P<0.05. Disease free survival rates were 62.1% and 41.4% respectively, P<0.05. Pelvic recurrence rates were 31.0% and 17.2% respectively P<0.05. More serious side effects were found in the chemoradiotherapy group. Especially in bone marrow inhibition and reaction of digestive tract, Which could be alleviated. Conclusion Concurrent chemotherapy and radiotherapy in medium term and advanced cervical carcinoma can increase treatment effect and raise the survival of the patients ,obviously improve the short term curative effect. Toxicity of patients was increasing but the patients could tolerate.
Key words:Cervical cancer;Concurrent chemoradiotherapy;Theraputic effect;Adverse effect。