目的 探究TC化療聯(lián)合放療治療術(shù)后高危子宮內(nèi)膜癌的臨床療效及毒副反應.方法：選取2008年2月—2009年2月無錫市第四人民醫(yī)院收治的術(shù)后高危子宮內(nèi)膜癌患者82例,隨機分為對照組(41例)和治療組(41例).對照組術(shù)后行放射治療,治療組術(shù)后行TC化療方案聯(lián)合放療.計算兩組患者腫瘤的復發(fā)率、生存率以及藥物的毒性作用發(fā)生情況.結(jié)果：治療組陰道、盆腔復發(fā)率,腹膜后淋巴結(jié)、肺的遠處轉(zhuǎn)移率均顯著低于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).治療組5年生存率高于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).治療過程中,兩組患者均可發(fā)生皮膚反應、胃腸道反應(包括惡心、嘔吐、腹瀉)、骨髓抑制、神經(jīng)毒性、泌尿系統(tǒng)毒性反應等,其中,治療組骨髓抑制發(fā)生率高于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).結(jié)論：TC化療聯(lián)合放療治療術(shù)后高危子宮內(nèi)膜癌是一種有效的治療方式,局部復發(fā)率、遠處轉(zhuǎn)移率以及5年生存率均明顯優(yōu)于單純放療方案,但聯(lián)合治療的骨髓抑制作用明顯,需密切關(guān)注患者血細胞水平,必要時輔以造血因子進行治療.

Objective To investigate the clinical effect and toxicity of TC chemotherapy combined with radiotherapy in treatment of high-risk endometrial cancer after surgery. Methods Patients (82 cases) with high-risk endometrial cancer after surgery who came to the Fourth People's Hospital of Wuxi City from February 2008 to February 2009 were randomly divided into control (41 cases) and treatment (41 cases) groups. The patients in the control group were given radiotherapy after surgery, while the patients in the treatment group were given TC chemotherapy combined with radiotherapy. The rates of tumor recurrence and survival in the two groups were calculated, and the toxic effects of drugs were observed. Results The recurrence rate of vagina and pelvic, and the distant metastasis rate of retroperitoneal lymph nodes and lung in treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Five year survival rate of the treatment group was higher than that of control group, with significant difference between two groups (P < 0.05). Toxicity reaction such as skin reaction, gastrointestinal reaction (included nausea, vomiting, diarrhea), bone marrow suppression, neurotoxicity, and urinary tract reaction happened in two groups during the course of treatment. The rate of bone marrow inhibition in the treatment group was higher than that in the control group, with significant difference between two groups (P < 0.05). Conclusion TC chemotherapy combined with radiotherapy is an effective treatment for high-risk endometrial cancer after surgery, and the local recurrence rate, distant metastasis, and five year survival rate are significantly better than pure radiotherapy. But the combination treatment has the disadvantage of bone marrow suppression, the blood cell levels of the patients needs to be paid close attention, and hematopoietic factor should be complementally used when necessary.

無錫市科技發(fā)展資金資助項目(CSE31N1316)