| Objective: To investigate the feasibility of clinical application of extended field modulation and simultaneous chemotherapy for cervical squamous carcinoma with abdominal aorta and common iliac artery lymph node metastasis.Methods: 74 cases of cervical squamous carcinoma first examined in our hospital were studied prospectively.The patients were diagnosed by CT,MRI,PET-CT and other imaging methods.To extend the field to adjust synchrotron chemotherapy,observe side effects,curative effect,survival rate,prognostic factors and other aspects.The measurement data uses the mean ± standard deviation(` x±S)test.,Log-rank test method is used for single-factor survival analysis,and single-factor analysis is incorporated into multi-factor COX regression analysis.Results: 74 patients had completed extended field strength and simultaneous chemotherapy,and the median follow-up time was 30 months(3-60 months).1.Recent efficacy: CR is 71 cases,PR is 3 cases,CR + PR is 74 cases,SD is 0cases,PD is 0 cases,total effective 74 cases,total effective rate is 100 %(74/74).2.Long-term efficacy: 2 years total survival rate of 80 %,2 years no progress survival rate of 60 %;The total survival rate for 3 years is 69.2 %,and the total survival rate for 5 years is 20 %;3 years of no progress survival rate: 52.3 %,5years of no progress survival rate: 10.8 %.3.Further analysis showed that: 3 years and 5 years of OS in patients with abdominal aortic lymph node metastasis combined with parathyroid lymph node metastasis were 49 % and 27.81 % respectively,and only 3 years and 5 years of OS in patients with abdominal aortic parathyroid lymph node metastasis were56 % and 32.46 % respectively.The 3 years and 5 years of OS in patients with peripheral iliac lymph node metastasis were 51 % and 29.99 %,respectively,P& lt;0.05,the difference is statistically significant.4.Cervical tumor diameter & lt;The 3 years and 5 years OS of 4cm patients were 45.57 % and 26.57 % respectively;The 3 years and 5 years OS of cervical cancer patients who ? 4cm were 36.28 % and 19.34 %,respectively.P & lt;0.05,the difference is statistically significant.5.The degree of pathological differentiation was 39 % and 22.2 % of the patients with low differentiation in 3 years and 5 years of OS respectively;The 3years and 5 years of OS of patients with differentiation were 49 % and 27.05 %respectively;The 3 years and 5 years of OS for highly differentiated patients were 57 % and 31.78 % respectively.P & lt;0.05,the difference is statistically significant.6.Patients with cervical cancer with radiotherapy days > 56 days 3 years and 5years OS were 32.26 % and 25.58 % respectively;The 3 years and 5 years of OS for patients with cervical cancer of 56 days were 41.59 % and 30.45 %,respectively.P & lt;0.05,the difference is statistically significant.7.3 years and 5 years of OS for patients with cervical cancer whose number of sensitization ? 3 times was 40.61 % and 29.93 % respectively;The 3 years and 5years of OS for cervical cancer patients were 31.43 % and 25.36 % respectively.P & lt;0.05,the difference is statistically significant.8.Acute toxicity,the number of I-II levels of bone marrow inhibition accounted for 56.6 %(42/74).The number of people with III-IV degree bone marrow inhibition accounted for 12.2 %(9/74).The number of people with I-II gastrointestinal side reactions accounted for 66.2 %(49/74).The number of people with type III gastrointestinal side reactions accounted for 6.8 %(5/74).The number of people with I-II urinary side reactions accounted for12.2 %(9/74).No Class III-IV urinary system side effects.9.Late toxicity: All patients had no late bone marrow inhibitory side effects,mainly 3 cases of radiocolitis;5 Cases of radioactive cystitis;Eight cases of cervical vaginal stenosis.10.The results of single factor analysis showed that: metastatic lymph node size,pathological type(degree of differentiation),diameter of cervical tumor,lymph node metastasis site,number of days of radiotherapy,number of sensitization during radiotherapy,pre-treatment depression,etc..The prognosis of cervical squamous carcinoma extended field modulation and synchronous chemotherapy Influencing factors.11.The results of multi-factor analysis showed that: the number of sensitization during radiotherapy,the pathological type(degree of differentiation),the diameter of cervical tumor,the location of lymph node metastasis,and the number of days of radiotherapy(P<UNK> 0.05)were independent prognostic factors.Research findings:Patients with cervical squamous carcinoma with abdominal aorta and iliac lymph node metastasis have extended field modulation and simultaneous chemotherapy.The effect is good and the side effects are small,and it is worth clinical promotion. |
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