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題名 | Survival Advantages and Complications of Adjuvant Therapy in Early-Stage Cervical Cancer with Pelvic Node Metastasis=早期子宮頸癌併骨盆腔淋巴腺轉移之術後輔助性治療:其效益及併發症之評估 |
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作者 | 林浩; 張簡展照; 張旭陽; 梁雲; | 書刊名 | 長庚醫學 |
卷期 | 21:4 1998.12[民87.12] |
頁次 | 頁383-390 |
分類號 | 417.2832 |
關鍵詞 | 子宮頸癌; 骨盆腔淋巴腺轉移; 輔助性治療; Cervical cancer; Pelvic node metastasis; Adjuvant therapy; |
語文 | 英文(English) |
中文摘要 | 背景:早期子宮頸癌併骨盆腔淋巴腺轉移之病人,為了要提高存活率,往往在術 後需追加輔助性治療,本篇目的在評估不同輔助性治療其效益及併發症。 方法:我們收集1986年7月至1994年12月於本院接受根治性子宮及骨盆腔淋巴腺切除的 Ⅰb-Ⅱa期子宮頸癌病人,總共87個有淋巴腺轉移,這87個病人依接受不同的輔助性治療可 分為3組,第一組為放射治療(43位),第二組為化學治療(23位),第三組為放射加上化學 治療(21位)。 結果:5年無復發存活率為第一、二、三組分別為63%、62%、51%,而復發率分別為32.6 %,39.1%、47.6%,都沒有達到統計意義之差別,但復發地點卻有統計上之差異,第一組 及第三組之病人其復發地點79%及80%為遠端,反觀第二組才占33%,p值0.020,另外在併 發症方面,第二組也有明顯較少的白血球降低,腳部淋巴水腫及蜂組織炎,乙狀直腸炎及小 腸阻塞。 結論:雖然我們無法證實那一種輔助性治療最佳,但我們仍認為化學治療為最好的輔助性治 療因為其引起之併發症最少。 |
英文摘要 | Background: Patients with early-stage cervical cancer who have pelvic node metastasis usually need adjuvant therapy after surgery for important of the length of survival. We attempted to determine the survival advantages and complications associated with different adjuvant therapeutic modalities. Materials and Methods: Eighty-seven patients with clinical stage Ⅰb and Ⅱa cervical cancer were treated with radical hysterectomy from July 1986 through December 1994 were reviewed retrospectively. All had had lymph node metastasis. The patients were divided into three groups according to the different adjuvant therapeutic approaches unilized: radiation(group Ⅰ, n=43), chemotherapy(group Ⅱ, n=23), and chemoirradiation(group Ⅲ, n=21). Results: There was no significant difference among these three groups in the 5-year relapse-free survival rate(group Ⅰ: 63%, group Ⅱ:62%, group Ⅲ:51%, p=0.785). The recurrence rats among these three groups were found to be similar (group Ⅰ:32.6%. group Ⅱ:39.1%, group Ⅲ: 47.6%, p=0.331). However, most of the recurrence in patients who had received pelvic radiation was at a distant site (groupⅠ:79%, groupⅢ:80%) as compared to the patients who had received chemotherapy only(groupⅡ:33%), and the differences were significant(p=0.020). The rates of complications, such as severe leukopenia, lymphedema with cellulitis, proctosigmoiditis and ileus, were found to be lower in the chemotherapeutic group. Conclusion: Although we failed to demonstrate the survival advantages of different adjuvant therapeutic approaches, we still favor chemotherapy as an adjuvant basis because it is the least toxic of the regimens. |
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