探讨晚期宫颈癌综合治疗的最佳有效方案。

选择自1990年6月至2010年6月，在汕头大学附属粤北人民医院妇产科、介入科及放疗科接受综合治疗的晚期宫颈癌患者中，病历资料完整的126例患者为研究对象。按照不同综合治疗方案对其进行分组。采取单纯后装(腔内后装放射治疗)+ ⁶⁰Co外照射治疗患者，纳入A组(n=46);行双侧子宫动脉化疗栓塞术患者，纳入B组(n=26);行子宫动脉化疗栓塞术+后装+⁶⁰Co外照射治疗患者，纳入C组(n=19);行单纯中子刀直线加速器外照射治疗患者，纳入D组(n=35)(本研究遵循的程序符合汕头大学附属粤北人民医院人体试验委员会所制定的伦理学标准)。A，B，C及D组患者年龄、宫颈癌分期、分类等比较，差异无统计学意义(P>0.05)。采用回顾性分析法对4组患者的治疗效果进行比较。

C组患者阴道流血停止率、肿块缩小率、3及5年生存率明显优于A，B，D组(P<0.05)，临床死亡率(以局部大出血为主)也明显低于A，B，D组(P<0.05)。

晚期宫颈癌综合治疗方案以子宫动脉化疗栓塞术或子宫动脉化疗栓塞术+后装+⁶⁰Co外照射治疗最有效。因本研究样本量较小，是否值得临床推广应用，尚需大样本、多中心前瞻性随机对照研究进一步证实。

To observe the best approach of combined therapy of the advanced cervical cancer.

From June 1990 to June 2010, 126 women with advanced cervical carcinoma were divided into four groups according to combined therapy regimen. Group A (n= 46) underwent ⁶⁰Co external beam radiotherapy + intracavitary radiotherapy. Group B (n=26) underwent interventional uterine arterial chemoembolization. Group C (n=19) underwent intracavitary radiotherapy + ⁶⁰Co external beam radiotherapy with accelerator linear after interventional uterine arterial chemoembolization. Group D (n= 35) underwent radiotherapy by neutron knife and accelerator linear. The procedure of this study was consistent with ethical standard established by the committee of investigation in human beings of Affiliated Yue Bei People's Hospital of Shantou University Medical College. Informed consent was obtained from all participates. There had no significant differences of ages, degrees of cervical carcinoma, classifications, clinical stages between two groups. The therapeutic efficacy among four groups were conducted by retrospective analysis.

Therapeutic efficacy (haltting colporrhagia, tumoral minification and three- and five- years survival rates) in group C were significance better than those in other three groups (P< 0.05). Clinical death rate in group C had statistically significant difference than those in other three groups (P<0.05).

It is optimization that intracavitary radiotherapy or neutron knife and electron beam radiotherapy with accelerator linear after interventional uterine arterial chemoembolization to treat advanced cervical carcinoma.