| Objective:The main purpose of this study is to investigate the clinical effectiveness of different postoperative adjuvant therapy for the cervical carcinoma patients with recurrence risk factors,so as to guide clinical therapy.Method:This study retrospectively analyze 160 cases,the cervical carcinoma patients who are treated by gynecology department of the First Affiliated Hospital of Dalian Medical University from January 1,2004 to December 31,2013.These cases include 39 cases with high risk factor,classified into there groups(chemo-radiotherapy group (22 cases)..radiotherapy group (3 cases) and chemotherapy group (14 cases)),and 71 cases with intermediate risk factor,classified into four groups(chemo-radiotherapy group (16 cases),radiotherapy group (23 cases), chemotherapy group (22 cases) and no adjuvant therapy group (10 cases)).The comparative analysis mainly includes disease-free survival rate, pelvic recurrence rate and distant metastases rate.Results:1. The overall prognosis of high risk factor and intermediate risk factorThe 3-year cumulative disease-free survival rate of patients with high risk factor was 79.48%,and the 5-year cumulative disease-free survival rate was 76.92%,9 cases recurred within 3 year,10 cases within 5 year, the recurrence rate was 25.64%,the total mortality rate was 23.06%. The 3-year cumulative risk factors-free survival of patients with intermediate factor was 87.32%,and 5-year cumulative disease-free survival rate was 85.91%,10 cases recurred within 3 year,11 case within 5 year, the recurrence rate was 15.49%,the total mortality rate was 14.08%. There was no significant difference between the two groups(P> 0.05).2.patients with intermediate risk factorsThe 3-year cumulative disease-free survival rate of chemo-radiotherapy group, radiotherapy group, chemotherapy group and no therapy group were 93.81%、86.93%、 95.52%、70.03%,5-year cumulative disease-free survival rate were 93.81%、86.93%、 90.08%、60.29%.1 case,3 cases,2 cases,3 cases recurred respectively within 3 year,and 1 case,3 cases,3 cases,4 cases within 5 year,the recurrence rate of 4 groups were 6.25%、13.04%、13.63%、40%.Compared with no therapy group, the disease-free survival rate of chemo-radiotherapy group, radiotherapy group and chemotherapy group were significantly higher(P<0.05).And the 3 groups have no statistical difference between each other (P> 0.05).The pelvic recurrence and distant metastasis rate of the 3 group were higher than no therapy group,but P>0.05.2.patients with high risk factorsThe 3-year cumulative disease-free survival rate of chemo-radiotherapy group, radiotherapy group, and chemotherapy group were 85.82%、100%、70.73%,5-year cumulative disease-free survival rate were 81.17%、100%、70.73%.5 case,0 cases,4 cases recurred respectively within 3 year,and 5 case,0 cases,5 cases within 5 year,the recurrence rate of 3 groups were 22.72%、0%、35.71%.Compared with each other, the disease-free survival rate of 3 group have no statistical difference (P> 0.05).The pelvic recurrence and distant metastasis rate both have no difference (P>0.05).Conclusion:1. Postoperative adjuvant therapy increase survival rate, and reduce the rate of pelvic recurrence and distant metastasis, significantly improving the prognosis of cervical carcinoma with recurrence risk factors.2. Chemo-radiotherapy, radiotherapy and chemotherapy all increase the 3-year and 5-year survival rates,both are choices of postoperative adjuvant therapy for cervical carcinoma with intermediate risk factors.But compare with each other,the three therapy have the equivalent therapeutic effect, cannot choose out the best one.3. For cervical carcinoma patients with high risk factors, chemo-radiotherapy means a good therapeutic effect,could be a preferential therapy.Chemotherapy also offers a viable option,but need large sample experiment to further exploration. |
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