摘要
目的：探讨有效的治疗复发宫颈癌患者的化疗方案。方法：回顾性分析中国医学科学院肿瘤医院1998年1月至2007年12月治疗54例宫颈癌复发的治疗情况。结果：54例复发患者中，11例为根治术后复发，43例为放疗（包括术后放疗）后复发，照射野内复发患者24例；照射野外复发（包括初次手术后未行辅助放疗的复发患者）30例。复发诊断时平均年龄为（46．7±1．442）岁（27～70岁），中位年龄45岁。距初次治疗结束后的平均复发时间为（13．80±2．344）个月（3～96个月），中位复发时间8个月。54例患者中，43例SCC升高，升高比例达79．6％。54例复发患者中，紫杉醇联合卡铂／顺铂化疗24例患者，另有12例采用顺铂加其他药物化疗肿瘤进展而改用紫衫醇联合顺铂／卡铂化疗；顺铂加其他药物化疗30列患者，另有6例因紫杉醇联合顺铂／卡铂化疗无效而改为顺铂加其他药物化疗。紫杉醇联合卡铂加顺铂化疗的24例患者中，有效率（CR＋PR）58．33％（14／24），其中照射野内复发化疗的有效率40％（4／10），低于照射野外复发患者化疗的有效率66．7％（10／14）；顺铂加其他药物化疗的患者30例，有效率13．33％（4／30），其中15倒照射野内复发者有效率6．67％（1／15），15例照射野外复发者有效率20％（3／15）。紫杉醇联合铂类化疗的有效率高于顺铂加其他药物化疗的有效率（X2=14．351，P〈0．001）。在紫杉醇联合化疗患者中，虽然照射野外复发灶的有效率为66．7％，高于照射野内复发灶40％的有效率，但差异不显著（X2=1．67，P=0．20）；顺铂加其他药物化疗方案的患者，照射野内复发灶的有效率6．67％，照射野外复发灶的有效率为20％，差异性不显著（X2=1．17，P=0．30）。两组化疗患者Ⅲ～Ⅳ度骨随抑制无显著性差异（X2=0．069，P=0．80）。54例患者生存时�
Objective： To discuss effectual chemotherapeutic regimens of recurrent carcinoma of the cervix. Methods： A retrospective analysis and study of the data of 54 patients with recurrent cervical cancer, who were treated with combined therapy of paclitaxel plus carboplatin/cisplatin with other drugs in the Cancer Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences during the period from 1998 to 2007, were conducted. Results： Recurrence after rad- ical surgery occurred in 11 of the 54 patients, and post-radiotherapeutic relapse occurred in the other 43 patients （including those undergoing postoperative radiotherapy）. In 24 of the 54 patients, relapse occurred at the irradiated sites and in the other 30 patients （including those without radiotherapy after undergoing initial surgery）, the recurrent cancer occurred out- side of irradiated sites. The mean age of the patients at diagnosis of the recurrence was 46.7± 1.442 （range, 27-70） years, with a median of 45. The mean recurrence time after initial surgery was 13.80 ± 2.34 （range, 3-96） months, and the median time of the relapse was 8 months. The serum SCCAg rose in 43 of the 54 recurrent patients, with a ratio of 79.6%. Of the 54 patients, 24 were treated with paclitaxel plus cisplatin （PT） or carboplatin （PC）, and 12 also received the same regimens because of progression of the disease after undergoing other cisplatin-based combined chemotherapy. Thirty of the 54 pa- tients were treated with combined chemotherapy of cisplatin plus other drugs. In addition, 6 patients received PT or PC regi- men because of ineffective cisplatin-based chemotherapeutics. The overall response rate was 58.33% （14/24）, including CR±PR, in the 24 patients receiving PT or PC regimen, whereas the response rate was 40% （4/10） in the patients with recurrence at the irradiated sites, which was lower than that of 66.7% （10/14） in the patients with relapse outside of the irradiated sites. The response rate of 30 patients rece
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第14期825-830,共6页
Chinese Journal of Clinical Oncology
关键词
子宫颈癌
复发
化疗
紫杉醇
铂类
Carcinoma of the cervix
Recurrence
Chemotherapy
Paclitaxel
Cisplatin/carboplatin
