热疗、化疗联合放疗治疗宫颈癌的疗效观察Curative effect observation of thermotherapy,chemotherapy united with radiotherapy on cervical cancer
李雅琪,龚勋,罗连英,廖国芳,马燕,张瑜,杨炜婷,吴忠秀
摘要(Abstract)：
目的观察腹腔热疗联合静脉化疗、放疗治疗宫颈癌的临床疗效及不良反应。方法将病理检查确诊的Ⅱb～Ⅲb期宫颈癌患者随机分为放化组39例和热放化组42例,放化组给予外照射及腔内照射后,多西他赛75 mg/m2+顺铂70 mg/m2静脉滴注化疗;热放化组:在放疗后1周给予多西他赛75 mg/m2静脉滴注,顺铂70 mg/m2行腹腔化疗,腹腔灌注顺铂后行腹部高频加热1 h,温度为41～45℃。用药期间动态监测生命体征、观察不良反应的发生等,6周期后评价疗效。结果放化组近期有效率为49%,热放化组为83%,2组比较有显著性差异(P<0.05);热放化组完全缓解率为55%,明显高于放化组的28%,2组比较有显著性差异(P<0.05);热放化组的改善率67%高于放化组的改善率38%,2组比较有显著性差异(P<0.05);热放化组治疗过程中的恶心呕吐及骨髓抑制引起的血细胞下降高于放化组,2组比较有显著性差异(P<0.05)。结论热疗、化疗联合放疗治疗宫颈癌可显著提高治疗效果,无严重的并发症,是中晚期宫颈癌治疗中的一种安全有效的方法。
关键词(KeyWords)： 宫颈癌;腹腔热疗;放疗;化疗
基金项目(Foundation):
作者(Author): 李雅琪,龚勋,罗连英,廖国芳,马燕,张瑜,杨炜婷,吴忠秀
参考文献(References)：
- [1]胡长耀,于世英.肿瘤临床诊疗指南[M].北京:科学出版社,1999:368
- [2]郭娜,刘辉.复发性宫颈癌的治疗进展[J].华西医学,2008,23(5):1234-1235
- [3]Symonds P.Chemoradiation:the new gold standard for non-surgicaltreatment of cervical cancer[J].Clin Oncol(R Coll Radiol),2002,14(3):201-202
- [4]张彩红.同步热放化疗治疗中晚期宫颈癌的临床及对细胞凋亡相关蛋白表达的研究[D].广西:广西医科大学,2009
- [5]Kampinga HH,Dynlacht JR,Dikomey E.Mechanism of radiosensiti-zation by hyperthermia(>or=43 degrees C)as derived from studieswith DNA repair defective mutant cell lines[J].Int J Hyperther-mia,2004,20(2):131-139
- [6]Takahashi A,Matsumoto H,Nagayama K,et al.Evidence for the in-volvement of double-strand breaks in heat-induced cell killing[J].Cancer Res,2004,64(24):8839-8845
- [7]Othman T,Goto S,Lee JB,et al.Hyperthermic enhancement of theapoptotic and antiproliferative activities of paclitaxel[J].Pharma-cology,2001,62(4):208-212
- [8]Tsuda H,Tanaka M,Manabe T,et al.Phase I study of combined ra-diation,hyperthermia and intra-arterial carboplatin for local recur-fence of cervical cancer[J].Ann Oncol,2003,14(2):298-303
- [9]Jones EL,Samulski TV,Dewhirst MW,et al.A pilot Phase II trim ofconcurrent radiotherapy,chemotherapy,and hyperthermia for locallyadvanced cervical carcinoma[J].Cancer,2003,98(2):277
- [10]Bergs JW,Franken NA,Haveman J,et al.Hyperthermia,cisplatinand radiation trimodality treatment:a promising cancer treatment,Areview from preclinical studies to clinical application[J].Int J Hy-perthermia,2007,23(4):329-341
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