| Objectives By observing the clinical efficacy and adverse reactions of deep pelvic hyperthermia combined with concurrent chemoradiotherapy in the treatment of advanced cervical squamous cell carcinoma,to explore a safe and effective treatment method for advanced cervical squamous cell carcinoma,and to provide a scientific basis for improving the therapeutic effect of advanced cervical squamous cell carcinoma.Methods A total of 120 patients with advanced cervical squamous cell carcinoma admitted to the department of gynecology,The Third Hospital of Chengde from February2015 to February 2017 were selected as the research subjects for retrospective analysis.60patients in the control group received pelvic concurrent chemoradiotherapy+intravantral brachytherapy,and 60 patients in the observation group received pelvic deep thermal therapy-assisted concurrent chemoradiotherapy+intravantral brachytherapy.Statistical analysis of the clinical efficacy of the two groups,including the efficacy at 1 month after the end of radiotherapy,the efficacy at 3 months after the end of radiotherapy,tumor regression at the end of the whole radiotherapy,tumor local control rate,i.e,the proportion of tumor disappearance at 3 months after the end of radiotherapy,scc-Ag changes,2-year tumor-free survival rate,tumor recurrence rate and distant metastasis rate.According to the statistics of the adverse reactions of the two groups,adverse reactions of radiotherapy and chemotherapy include:acute adverse reactions within 3 months from the start of radiotherapy,and long-term adverse reactions after 3 months from the start of radiotherapy;Common adverse reactions of hyperthermia and radiotherapy:acute adverse reactions within 3 months from the start of treatment,and long-term adverse reactions after 3 months from the start of treatment.Results 1 Basic data analysis of the subjects:there was no difference in age,Karuafsky score,weight,between the observation group and the control group(t=0.291,-0.454,1.117,P>0.05).There was no difference in the distribution of initial diameter,in pathological differentiation of tumor,in clinical stage(Z=-0.196,-0.476,-0.314,P>0.05).2 The object of study of clinical indicators analysis:1)Radiation effect after 1 month:Observation group total effective rate was 93.3%,and the control group total effective rate was 78.3%.Observation group of patients with radiation over 1 month treatment effectiveness was better than that of control group,so the two comparative difference was statistically significant(Z=2.821,P<0.05).Radiotherapy curative effect after the end of three months:Observation group total effective rate was 95.0%,and the control group total effective rate was 81.7%.Observation group of patients with radiation over 3 months treatment effectiveness was better than those of control group,so the comparative difference was statistically significant(Z=2.779,P<0.05).2)Tumor regression:At the end of radiotherapy in the observation group,48 cases of tumor regression were complete,and 12 cases of tumor regression were not complete,and the tumor regression rate was 80.0%.At the end of radiotherapy,38 patients in the control group had a complete regression of tumor,while22 patients had not,and there was a complete regression rate of 63.3%.Comparison of tumor regression at the end of radiotherapy between the two groups showed that there was a significant difference in tumor regression between the two groups(χ~2=4.100,P<0.05).3)Local control rate:The assessment standard was that after the end of the whole radiotherapy,the number of patients in the observation group with local complete control of the tumor,such as the cervix and vagina,disappeared for 3 months was 54,with a local control rate of 90.0%.In the control group,45 patients had local tumor complete control,and the local control rate was 75.0%.The difference was statistically significant(χ~2=4.670,P<0.05).4)SCC-Ag index analysis before and after treatment:Before treatment,SCC-Ag index of observation group was(3.56±1.52)ng/m L,while at the end of treatment that of control group was(4.91±1.43)ng/m L,with no significant difference between groups(t=2.233,P>0.05).After treatment,the SCC-Ag index of squamous cell carcinoma antigen in the observation group was(0.56±0.23)ng/m L and that in the control group was(1.56±0.44)ng/m L.The change of SCC-Ag index in the observation group was significantly lower than that in the control group,with significant difference between the two groups(t=2.432,P<0.05).5)In the observation group,the 2-year tumor-free survival rate was 71.7%,and the recurrence rate was 16.7%,and the distant metastasis rate was21.7%.The 2-year tumor-free survival rate in the control group was 53.3%,and the recurrence rate was 33.3%,and the distant metastasis rate was 28.3%.The 2-year tumor-free survival rate in the observation group was higher than that in the control group,while the recurrence rate and distant metastasis rate were lower than those in the control group.There was significant difference between the two groups(χ~2=4.302,4.440,4.093,P<0.05).3 ADR analysis 1)Adverse reactions of radiotherapy and chemotherapy in acute stage:There were no significant differences in bone marrow suppression,nausea and vomiting,rectal reaction,bladder reaction,and dermatitis in the observation group compared with the control group(χ~2=0.063,0.042,1.563,0.839,0.839,P>0.05).However,in terms of the severity of adverse reactions,the rates of second-degree rectal reaction,bladder reaction,and dermatitis in the observation group were significantly lower than those in the control group,and the differences were statistically significant(χ~2=8.571,6.536,6.508,P<0.05).2)Long-term adverse reactions of radiotherapy and chemotherapy:There was no significant difference in bone marrow suppression,nausea and vomiting,rectal reaction,bladder reaction and dermatitis between the observation group and the control group.(χ~2=0.000,0.100,0.076,0.000,0.000,P>0.05).3)The common adverse reactions of hyperthermia and radiotherapy mainly cause local pain and subcutaneous induration.Compared with the control group,there was no significant difference between the short-term and long-term local pain rates in the observation group(χ~2=0.814,P>0.05).Although the rate of subcutaneous induration in the observation group is higher than that in the control group in the near future,there is no significant difference in the rate of subcutaneous induration between the two groups from the short-term and long-term overall observation,and the difference is not statistically significant(χ~2=1.497,P>0.05).Conclusions 1 The treatment of advanced cervical squamous cell carcinoma with pelvic deep hyperthermia combined with concurrent radiotherapy and chemotherapy can improve the effective rate of treatment,improve the prognosis,improve the 2-year tumor-free survival rate,and reduce the 2-year tumor recurrence rate and distant metastasis rate.2 Pelvic deep hyperthermia combined with concurrent chemoradiotherapy in the treatment of advanced cervical squamous cell carcinoma can not avoid adverse reactions such as bone marrow suppression,nausea and vomiting,bladder and rectal skin,but within the patient’s tolerance range,this method is safe and effective.Figure 0;Table 20;Reference 105... |
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