消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌的临床研究
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摘要
[目的]探讨消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌的临床治疗效果。[方法]将162例不可切除的老年局部晚期宫颈癌患者随机分为观察组和对照组,每组81例。对照组均给予CT引导的三维插植腔内后装放疗同步化疗,观察组则在对照组基础上另给予消癌平片治疗。治疗后,评价2组近期疗效。治疗期间,密切观察2组出现的毒副作用发生率。治疗前后,检测2组外周血中IgG、IgA、CD3~+、CD4~+及CD8~+含量。治疗结束后,对患者进行为期3 a的随访,统计患者治疗1、2、3 a的生存率、无疾病进展生存时间(PFS)和总生存时间(OS)。[结果]近期疗效评价结果显示,观察组总有效率显著高于对照组(P<0.05)。治疗期间,观察组腹痛腹泻、恶心呕吐、白细胞计数降低、血小板降低、肝功能损伤、放射性直肠损伤、放射性膀胱损伤及血红蛋白降低等毒副作用发生率均显著低于对照组(P<0.05)。治疗后,观察组IgG、IgA、CD3~+、CD4~+及CD8~+均显著高于对照组(P<0.05)。远期疗效评价结果显示,观察组1 a生存率、2 a生存率、3 a生存率、平均PFS及平均OS均显著高于对照组(P<0.05)。[结论]消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌疗效较好,且可有效降低毒副作用,提高患者免疫功能,延长患者生命。
[Objective] To evaluate the effect of Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer. [Methods] The 162 elderly patients were divided into observe group and control group, 81 cases in each group. Control group was treated by CT image-based interstitial brachytherapy, while the Xiaoaiping pian was given in observe group based the control group. After the treatment, the effects were observed. During the treatment, the adverse actions rates were observed in the two groups. Before and after the treatment, the levels of IgG, IgA, CD3~+, CD4~+and CD8~+were detected in the two groups. After the treatment, the OS, PFS, 1 year, 2 years and 3 years survival rates were observed.[Results] In the evaluation of recent effect, the total effective rate was significantly higher in observe group than control group( P<0.05).After the treatment, the levels of IgG, IgA, CD3~+, CD4~+and CD8~+were significantly higher in observe group than control group(P<0.05).During the treatment, the rates of abdominal pain and diarrhea, nausea and vomiting, white blood cell count reduction, platelet reduction,liver function damage, radioactive rectal damage, radioactive bladder injury and hemoglobin reduction were significantly lower in observe group than control group(P <0.05). In long-term evaluation, the OS, PFS, 1 year, 2 years and 3 years survival rates were significantly higher in observe group than control group(P <0.05). [Conclusion] Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer has a good effect, could promote the immune function, remit adverse actions and extend the survival time in patients.
[Objective] To evaluate the effect of Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer. [Methods] The 162 elderly patients were divided into observe group and control group, 81 cases in each group. Control group was treated by CT image-based interstitial brachytherapy, while the Xiaoaiping pian was given in observe group based the control group. After the treatment, the effects were observed. During the treatment, the adverse actions rates were observed in the two groups. Before and after the treatment, the levels of IgG, IgA, CD3~+, CD4~+and CD8~+were detected in the two groups. After the treatment, the OS, PFS, 1 year, 2 years and 3 years survival rates were observed.[Results] In the evaluation of recent effect, the total effective rate was significantly higher in observe group than control group( P<0.05).After the treatment, the levels of IgG, IgA, CD3~+, CD4~+and CD8~+were significantly higher in observe group than control group(P<0.05).During the treatment, the rates of abdominal pain and diarrhea, nausea and vomiting, white blood cell count reduction, platelet reduction,liver function damage, radioactive rectal damage, radioactive bladder injury and hemoglobin reduction were significantly lower in observe group than control group(P <0.05). In long-term evaluation, the OS, PFS, 1 year, 2 years and 3 years survival rates were significantly higher in observe group than control group(P <0.05). [Conclusion] Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer has a good effect, could promote the immune function, remit adverse actions and extend the survival time in patients.
引文
[1]张秀珍,李海滨,靳玉荣.局部晚期和复发性宫颈癌治疗进展[J].世界中医药,2015,10(2):1223-1226.
[2]Hong JH,Min KJ,Lee JK,et al.Prognostic value of the sum of metabolic tumor volume of primary tumor and lymph nodes using18F-FDG PET/CT in patients with cervical cancer[J].Medicine,2016,95(9):e2992.
[3]程璐,李林,谢旭.分子靶向药物治疗宫颈癌研究进展[J].实用药物与临床,2015,18(5):599-603.
[4]Vaccarella S,Franceschi S,Bray F.The incremental benefits of implementing effective cervical cancer screening[J].International Journal of Cancer,2016,138(1):254-255.
[5]宋云红.老年宫颈癌与中青年宫颈癌的临床及病理特点对比[J].中国老年学,2013,33(22):5600-5601.
[6]刘婷婷,孔为民.宫颈癌治疗现状及进展[J].中国医师进修杂志,2016,39(1):82-84.
[7]杨学宁,吴一龙.实体瘤治疗疗效评价标准-RECIST[J].循证医学,2004,4(2):85-90.
[8]白雪莲,武云.中晚期宫颈癌放化疗临床疗效评价方法的研究进展[J].癌症进展,2015,3:277-279.
[9]Hou Y,Yin M,Sun F,et al.A metabolomics approach for predicting the response to neoadjuvant chemotherapy in cervical cancer patients[J].Mol Biosyst,2014(10):2126-2133.
[10]喇建英,张凡.老年子宫颈癌患者生存情况及其影响因素分析[J].海南医学院学报,2015,21(4):565-567.
[11]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志:电子版,2015,11(2):1-6.
[12]周勇,杨勇,燕平,等.局晚期宫颈癌在CT引导下二维以及三维腔内后装放疗的治疗效果及副作用比较[J].中南医学科学杂志,2017,45(4):394-396.
[13]朱永刚,赵红福,程光惠,等.局部晚期宫颈癌三维适形近距离放疗CT与MRI定位的对比研究[J].中华放射肿瘤学杂志,2015,24(4):408-413.
[14]刘伟,梁晓春.中医药治疗宫颈癌研究进展[J].环球中医药,2013,6(7):554-558.
[15]张薇,王泽锋,王静,等.乌骨藤化学成分及其抗肿瘤活性[J].中成药,2017,39(2):334-338.
[2]Hong JH,Min KJ,Lee JK,et al.Prognostic value of the sum of metabolic tumor volume of primary tumor and lymph nodes using18F-FDG PET/CT in patients with cervical cancer[J].Medicine,2016,95(9):e2992.
[3]程璐,李林,谢旭.分子靶向药物治疗宫颈癌研究进展[J].实用药物与临床,2015,18(5):599-603.
[4]Vaccarella S,Franceschi S,Bray F.The incremental benefits of implementing effective cervical cancer screening[J].International Journal of Cancer,2016,138(1):254-255.
[5]宋云红.老年宫颈癌与中青年宫颈癌的临床及病理特点对比[J].中国老年学,2013,33(22):5600-5601.
[6]刘婷婷,孔为民.宫颈癌治疗现状及进展[J].中国医师进修杂志,2016,39(1):82-84.
[7]杨学宁,吴一龙.实体瘤治疗疗效评价标准-RECIST[J].循证医学,2004,4(2):85-90.
[8]白雪莲,武云.中晚期宫颈癌放化疗临床疗效评价方法的研究进展[J].癌症进展,2015,3:277-279.
[9]Hou Y,Yin M,Sun F,et al.A metabolomics approach for predicting the response to neoadjuvant chemotherapy in cervical cancer patients[J].Mol Biosyst,2014(10):2126-2133.
[10]喇建英,张凡.老年子宫颈癌患者生存情况及其影响因素分析[J].海南医学院学报,2015,21(4):565-567.
[11]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志:电子版,2015,11(2):1-6.
[12]周勇,杨勇,燕平,等.局晚期宫颈癌在CT引导下二维以及三维腔内后装放疗的治疗效果及副作用比较[J].中南医学科学杂志,2017,45(4):394-396.
[13]朱永刚,赵红福,程光惠,等.局部晚期宫颈癌三维适形近距离放疗CT与MRI定位的对比研究[J].中华放射肿瘤学杂志,2015,24(4):408-413.
[14]刘伟,梁晓春.中医药治疗宫颈癌研究进展[J].环球中医药,2013,6(7):554-558.
[15]张薇,王泽锋,王静,等.乌骨藤化学成分及其抗肿瘤活性[J].中成药,2017,39(2):334-338.