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目的探讨中晚期宫颈鳞癌放化疗后复发未控相关因素,为改进放化疗方案而提供依据。方法回顾性分析我院于2009年5月至2014年9月期间,放化疗治疗的73例中晚期宫颈鳞癌患者的临床资料,其中放化疗后复发未控患者16例,作为观察组;放化疗后无复发未控患者47例,作为对照组;对比两组患者的临床资料,并进行统计学检验分析,通过Logistic回归分析,探讨中晚期宫颈鳞癌放化疗后复发未控的独立危险因素。结果本组病例中,73例中晚期宫颈鳞癌患者,放化疗后复发未控16例,复发未控发生率为21.92%;通过Logistic回归分析显示,肿瘤低分化、肿瘤直径大于4cm、癌变转移、血红蛋白表达水平低于90g/L、化疗少于3个疗程、放疗超过8周,均作为中晚期宫颈鳞癌放化疗后复发未控的独立危险因素。结论中晚期宫颈鳞癌放化疗后复发未控的相关因素具有多样化,肿瘤低分化、肿瘤直径大于4cm、癌变转移、血红蛋白表达水平低于90g/L、化疗少于3个疗程、放疗超过8周均作为独立危险因素,需根据患者的实际情况,提供个体化的放疗化治疗。
Objective To investigate the factors related to the non-recurrence of advanced squamous cell carcinoma of the cervix after radiotherapy and chemotherapy in order to provide a basis for improving radiotherapy and chemotherapy regimen. Methods The clinical data of 73 patients with advanced squamous cell carcinoma of the cervix treated with radiotherapy and chemotherapy were retrospectively analyzed in our hospital from May 2009 to September 2014. Among them, 16 patients with uncontrollable recurrence after radiotherapy and chemotherapy were treated as observation group. 47 patients with no recurrence after chemotherapy were served as the control group. The clinical data of the two groups were compared and statistically analyzed. Logistic regression analysis was used to explore the independent risk factors of recurrence after advanced chemoradiotherapy . Results In this group of patients, 73 cases of advanced cervical squamous cell carcinoma, recurrence after radiotherapy and chemotherapy failed to control 16 cases, the recurrence rate was 21.92%; Logistic regression analysis showed that the tumor was poorly differentiated, the tumor diameter greater than 4cm, cancer metastasis , Hemoglobin expression level less than 90g / L, less than 3 courses of chemotherapy, radiotherapy for more than 8 weeks, were used as advanced cervical squamous cell carcinoma recurrence after radiotherapy uncontrolled independent risk factors. Conclusion The related factors of uncontrolled recurrence of advanced squamous cell carcinoma of cervical squamous cell carcinoma after radiotherapy and chemotherapy are diversified, the tumors are poorly differentiated, the diameter of tumor is more than 4cm, the metastasis of carcinoma is less than 90g / L, the chemotherapy is less than 3 courses, radiotherapy is more than 8 Weekly as an independent risk factor, according to the actual situation of patients, to provide personalized radiotherapy and chemotherapy.