不同辅助治疗方式对术后存在中危因素宫颈癌患者的疗效及生活质量分析

Analysis of the efficacy and life quality of cervical cancer patients with intermediate risk after operation by different adjuvant treatments

摘要:

目的： 比较单纯化疗或同步放化疗辅助治疗宫颈癌（IB1~IIA2）术后存在中危因素患者的临床疗效及远期毒副反应，并进行生活质量评估，探讨该类患者术后采用单纯化疗的可行性。方法： 回顾性分析2016年2月至2018年4月就诊于安徽省肿瘤医院妇瘤科术后宫颈癌存在中危因素的患者。入组患者均行标准宫颈癌手术，术后根据辅助治疗途径分为化疗组和同步放化疗组，通过治疗的有效性、远期毒副反应及生存质量等指标探讨2种辅助治疗方式的临床疗效及安全性。结果： 2组间的复发率（χ²=0.288，P=0.591）和病死率（χ²=0.238，P=0.625）比较差异均无统计学意义；化疗组的3年无进展生存率（87.70%）和3年总生存率（97.60%）高于同步放化疗组（分别为81.40%和89.70%），差异均无统计学意义（χ²=0.787，P=0.375；χ²=1.441，P=0.230）；化疗组（16.70%）淋巴水肿的发生率低于放化疗组（37.21%），差异有统计学意义（χ²=4.543，P=0.033）；化疗组的生活质量得分（88.28±5.84）高于放化疗组（78.60±8.32），差异有统计学意义（t=6.020，P<0.001）。结论： 单纯化疗辅助治疗IB1~IIA2期宫颈癌根治术后具有中危因素的患者，也能获得较好的临床效果，并且毒副反应略轻于放化疗组，可以作为一种备选的辅助治疗方式供临床选择。

Abstract:

Objective: To compare the effectiveness and long-term side effects of adjuvant therapy for patients with cervical cancer (IB1-IIA2) with intermediate-risk factors in pathology after chemotherapy alone or concurrent radiotherapy and chemotherapy, and to evaluate the quality of life and explore the feasibility of using chemotherapy alone for cervical cancer patients. Methods: Cervical cancer patients with intermediate risk factors after surgery in the Department of Gynecological Oncology, The First Affiliated Hospital of USTC West District/Anhui Provincial Cancer Hospital from February 2016 to April 2018 were retrospectively analyzed in this study. All patients underwent standard cervical cancer surgery, and were divided into chemotherapy group and concurrent radiotherapy and chemotherapy group according to the adjuvant treatment methods after surgery. The clinical efficacy and safety of the two adjuvant treatments were discussed through the indicators of treatment effectiveness, long-term toxic side effects and quality of life of the two groups. Results: There was no significant difference in cervical cancer recurrence (χ²=0.288, P=0.591) and mortality (χ²=0.238, P=0.625) between the two groups. The 3-year progression-free survival (87.70%) and 3-year overall survival (97.60%) of the radiotherapy and chemotherapy group were lower than those of chemotherapy group (81.40% and 89.70%, respectively), without significant differences (χ²=0.787, P=0.375; χ²=1.441, P=0.230). The incidence of lymphedema in the chemotherapy group (16.70%) was lower than that of the radiotherapy and chemotherapy group (37.21%), with significant differences (χ²=4.543, P=0.033). The quality of life scores of the chemotherapy group (88.28±5.84) were higher than those of the radiotherapy and chemotherapy group (78.60±8.32), with significant differences (t=6.020, P<0.001). Conclusion: Chemotherapy alone for adjuvant treatment of patients with intermediate risk factors after radical resection of IB1-IIA2 cer-vical cancer can also achieve better clinical results, and the side effects are slightly lighter than those in the radiotherapy and chemotherapy group, which can be used as an alternative adjuvant treatment.