摘要
目的观察同步放化疗治疗晚期宫颈癌的疗效并评价宫颈分泌物HPV-DNA及血清TNF-α作为疗效监测指标的可行性。方法 74例晚期宫颈癌患者随机分为同步放化疗组42例和单纯放疗组32例。单纯放疗组采用加速器体外照射加192Ir腔内后装治疗;同步放化疗组在放疗基础上加用化疗,方案为紫杉醇50 mg/m2加顺铂40 mg/m2,1次/周,共6周。采用第二代杂交捕获技术(HC-Ⅱ)和双抗体夹心酶联免疫吸附(ABC-ELISA)法检测治疗前后宫颈分泌物HPV-DNA表达及血清TNF-α含量。结果同步放化疗组的总有效率为90.5%,优于单纯放疗组的65.6%(P<0.05),且同步放化疗组患者59.5%的5年生存率亦高于单纯放疗组的40.0%(P<0.05)。同步放化疗组的骨髓抑制和胃肠道反应的发生率均较单纯放疗组高(P<0.05),但均不影响治疗过程。两组患者治疗后宫颈分泌物HPV-DNA阳性率及血清TNF-α含量均较治疗前明显下降。结论同步放化疗能明显提高晚期宫颈癌患者的5年生存率,宫颈分泌物HPV-DNA及血清TNF-α含量的变化,可作为晚期宫颈癌治疗效果的监测指标。
Objective To observe the therapeutic effect Of synchronous chemoradiation for advanced cervical cancer and evaluate the feasibility of cervical secretion HPV-DNA and serum TNF-α as monitoring indicators on curative effect. Methods Seventy-four patients of advanced cervical cancer were randomly divided into concurrent radiochemotherapy group（n=42） and simple radiotherapy group （n=32）. The patients of the simple radiotherapy group were treated with accelerator extracorporeal irradiation and ^192Ir intracavitary afterloading therapy, while the patients of the concurrent radiochemotherapy were treated not only with the radiotherapy mentioned above, but also with chemotherapy, which included paclitaxel 50 mg/m2 and cisplatin 40 mg/m2, once a week and a total of 6 weeks. Before and after treatment, the second-generation hybrid capture technology （HC-II） and double antibody sandwich enzyme linked immunosorbent assay （ABC-ELISA） were used to detect the cervical secretion HPV-DNA expression and serum TNF-α content, respectively. Results The overall response rate of the concurrent radiochemotherapy （90.5%） was better than that of the simple radiotherapy group（65.6%） （P〈0.05）, and the 5-year survival rate of the first group （59.5%） was also higher than that of the second group（40.0%） （P〈0.05）. Both the myelosuppression rate and gastrointestinal reaction rate of the the concurrent radiochemotherapy were much higher than those of the simple radiotherapy group （P〈0.05）, but should not affect the course of treatment. In both groups, the cervical secretion HPV-DNA positive rate and serum TNF-α levels decreased significantly after therapy （P〈O.01）. Conclusion Concurrent radiochemotherapy can significantly improve the 5-year survival rate of the patients with advanced cervical cancer, and the changes of cervical secretion HPV-DNA expression and serum TNF-α content can be used as monitorin~ indicators on curative effect.
出处
《实用医药杂志》
2011年第8期676-678,共3页
Practical Journal of Medicine & Pharmacy
