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目的探讨新疆地区ⅠB~ⅡA期宫颈癌不同治疗模式的疗效及并发症。方法回顾性分析本院215例ⅠB~ⅡA期宫颈癌患者的临床病理资料并随访其生存情况,分析总体及不同临床病理参数的5年生存率,采用Cox模型分析影响预后的独立因素;根据治疗方案将215例患者分为根治性手术(81例)、根治性放疗(65例)、术前辅助治疗(25例)及术后辅助治疗(44例),分析各种治疗模式的预后及并发症情况。结果总体5年生存率为79.3%。不同FIGO分期、族别、肿瘤直径、分化程度及术后病理高危因素的5年生存率差异均有统计学意义(P<0.05);Cox模型分析显示,FIGO分期、肿瘤直径及术后病理高危因素是宫颈癌预后的独立危险因素(P<0.05)。根治性手术、根治性放疗、术前辅助治疗及术后辅助治疗者的5年生存率依次为80.9%、82.5%、78.8%和72.4%,并发症发生率依次为25.9%、18.5%、24.0%和38.6%,差异均无统计学意义(P>0.05)。结论对术后有危险因素或术前肿瘤体积较大患者行相应辅助治疗可达到无危险因素患者根治性手术或根治性放疗的治疗效果,故建议临床工作中对不同患者施行个体化治疗,在保证治疗效果的前提下尽量减少并发症及患者治疗负担。
Objective To investigate the efficacy and complications of different treatment modalities for stage ⅠB ~ ⅡA cervical cancer in Xinjiang region. Methods The clinical and pathological data of 215 patients with stage ⅠB-ⅡA cervical cancer were retrospectively analyzed. The 5-year overall survival rate was analyzed. The independent variables influencing prognosis were analyzed by Cox model. According to the treatment 215 patients were divided into radical surgery (81 cases), radical radiotherapy (65 cases), preoperative adjuvant therapy (25 cases) and postoperative adjuvant therapy (44 cases). The prognosis and complications of various treatment modalities Symptoms. Results The overall 5-year survival rate was 79.3%. The 5-year survival rates of different FIGO staging, ethnicity, tumor diameter, differentiation and postoperative pathological risk factors were significantly different (P <0.05). Cox model analysis showed that the FIGO staging, tumor diameter and postoperative pathology were high Factors are independent risk factors of cervical cancer prognosis (P <0.05). The 5-year survival rates of radical surgery, radical radiotherapy, preoperative adjuvant therapy and postoperative adjuvant therapy were 80.9%, 82.5%, 78.8% and 72.4%, respectively, and the complication rates were 25.9%, 18.5% and 24.0 % And 38.6%, respectively, with no significant difference (P> 0.05). Conclusions The postoperative risk factors or preoperative tumor volume in patients with appropriate adjuvant therapy can reach the risk-free radical surgery or radical radiotherapy of the treatment effect, it is proposed in clinical practice of different patients with individualized treatment, in the To ensure the treatment effect under the premise of minimizing complications and patient treatment burden.