早期宫颈癌患者手术与放疗预后对比分析

摘要

Objective:To compare the long-term complications and quality of life of patients with stage ⅠB and stage ⅡA uterine cervical carcinoma by the treatment of surgery or radiotherapy.Methods:From August 2007 to August 2008,121 patients with uterine cervical carcinoma treated with surgery or radiotherapy and enrolled in this study were followed-up at least 2 years,among them 107 patients completed the Functional Assessment of Cancer Therapy -Cervix (FACT-Cx) questionnaire and complications questionnaire.Results:Constipation (P ＜ 0.001),dysuria (P＜ 0.001),urinary incontinence (P ＜ 0.01) and flushing (P ＜ 0.001) were statistically higher in the surgery group,while abdominal pain (P ＜ 0.01),diarrhea(P ＜ 0.001),and bloody stools (P ＜ 0.001) were higher in the radiotherapy group.Using factor analysis and introducing personal conditioned variables,pelvic neural dysfunction and sexual dysfunction were significantly higher in surgery group and intestinal dysfunction was higher in radiotherapy group.Comparison of FACT-Cx questionnaire showed that none of the item had any differences between these two treatment modalities.Conclusion:In early-stage uterine cervical cancer patients,surgery or radiotherapy resulted in different complications,whereas long-term quality of life showed no difference between these two treatments.These data were helpful for physicians to make good choice for individual patients.%目的:分析ⅠB期至ⅡA期宫颈癌患者手术或放疗治疗后长期并发症和生活质量.方法:收集我院2007年8月至2008年8月的121例接受手术或放疗的宫颈癌患者,随访2年.107患者完成了生活质量问卷及并发症问卷调查.结果:手术治疗组便秘(P ＜0.001)、排尿困难(P ＜0.001)、尿失禁(P＜0.01)、潮红(P＜0.001)均显著高于放疗组；放疗组腹痛(P＜0.001)、腹泻(P ＜0.001)、血便(P ＜0.001)均高于手术组.主成分回归分析,发现盆腔神经功能障碍和性功能障碍手术组较高,而肠功能障碍放疗组较高,差异具有统计学意义.FACT-Cx生活质量分析结果表明,这两种治疗方法生活质量无差异.结论:早期宫颈癌患者,手术或放疗导致不同并发症,但长期的生活质量无差异,这将有助于临床医生选择个体化治疗方法.