The Survival Analysis And The Comparison Of Complications About Synchronous Chemoradiotherapy Versus Pure Radiotherapy In The Treatment Of Locally Advanced Cervical Cancer

Objective:Through comparison and analysis the synchronouschemoradiotherapy and the pure radiotherapy in the treatment of locallyadvanced cervical cancer patients with the differences of5-year survival rateand complications, to explore the high benefit treatment pattern of locallyadvanced cervical cancer.Methods:About113cases admitted Ⅱ B-ⅣA period of cervical cancercases from2005-June to2007-June in the first affiliated hospital of guangximedical university divides by the synchronous chemoradiotherapy group68cases and the pure radiotherapy group45cases according to the treatment. Thepure radiotherapy group set of the conventional radiotherapy+high dose ratecavity brachytherapy. External exposure with6~15mv of Siemens linearaccelerator therapy apparatus, and intracavitary irradiation with the WD-HDR18close after installed, Ir192r radioactive sources. External exposureDT46~50Gy,2.0Gy/times, five times a week, and the radiation field includedthe upper bound on the edge between the lumbar spine,4lower obturator under 2cm, and with the vaginal invaded scope changes, the lateral reach dermapelvic most outside diameter1~2cm wide, common iliac and external iliacand iliac and sacral front and obturator lymph nodes are within range.Lumenloading after treatment point A DT36~42Gy,6Gy/week,1times A week. Thesynchronous chemoradiotherapy group put the radiotherapy using with the pureradiotherapy group,s principle, the chemotherapy begin from the fisrt day ofradiotherapy, using PF scheme：cisplatin (DDP)50~70mg/m2(2days)1~2days,5fluorouracil (5-Fu)750mg/m22~5days, intravenous drip,3weeks, atotal of3times. This research adopts the retrospective study, through outpatientservice way and telephone follow-up for all patients. Comparison the5-yearsurvival rate and the incidence of bone marrow suppression, gastrointestinalreaction，chronic radiation enteritis and chronic radiation cystitis between thetwo groups.Results:1.The bone marrow inhibition reaction rate of synchronouschemoradiotherapy group is100.00%, and the bone marrow inhibition reactionrate of the pure radiotherapy group is88.89%, difference between the twogroups has statistical significance (P<0.05)；the Ⅲ~Ⅳ degrees of bonemarrow inhibition reaction rate and the gastrointestinal reaction rate of thesynchronous chemoradiotherapy group are27.94%、23.53%，and the Ⅲ~Ⅳdegrees of bone marrow inhibition reaction rate and gastrointestinal reactionrate of the pure radiotherapy group are4.44%、6.67%，differences between thetwo groups have statistical significance (P<0.05); the rates about chronicradiation enteritis reaction and chronic radiation cystitis reaction of thesynchronous chemoradiotherapy group are16.18%、7.35%, and the rates aboutchronic radiation enteritis reaction and chronic radiation cystitis reaction of thepure radiotherapy group are11.11%、4.44%，no obvious statistical significance difference between the two groups (P <0.05).2. Put the5-year survival rate ofthe synchronous chemoradiotherapy group was significantly higher than thepure radiotherapy group (64.71%VS46.67%), the difference was statisticallysignificant (P<0.05).Conclusion:1.The synchronous chemoradiotherapy vers the pureradiotherapy in the treatment of locally advanced cervical cancer, although theincidence of the acute and chronic iradation enteritis and cystitis are did not seethe difference, but in the degree of gastrointestinal reaction, bone marrowsuppression are significantly increased.2. The synchronous chemoradiotherapyversus the pure radiotherapy can improve the5-year survival rate of locallyadvanced cervical cancer.