内科

目的探讨化疗联合阿帕替尼及调强放疗治疗老年中晚期宫颈癌患者的临床效果及不良反应发生情况。方法选取2014年1月至2017年1月在我院诊治的老年中晚期宫颈癌患者86例为研究对象，采用随机数字法分为观察组与对照组，每组43例。对照组患者给予静脉化疗+阿帕替尼治疗，观察组患者在对照组患者治疗的基础上给予调强放疗。治疗28 d为1个周期，共治疗2个周期。比较两组患者的临床疗效；比较两组患者治疗前后的血清鳞状细胞癌相关抗原（SCC-Ag）、癌胚抗原（CEA）水平；比较两组患者的不良反应发生情况以及1年、3年生存率。结果疗程结束后，观察组患者的临床疗效明显优于对照组，差异有统计学意义（P＜0.05）；两组患者的SCC-Ag、CEA水平均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义（P＜0.05）。治疗期间，两组患者骨髓抑制、消化道反应、直肠炎发生情况比较，差异均无统计学意义（P＞0.05）。观察组患者的1年、3年生存率均显著高于对照组，差异有统计学意义（P＜0.05）。结论化疗联合阿帕替尼及调强放疗治疗老年中晚期宫颈癌患者，可显著提高疗效，有效控制病情进展，提高患者的1年、3年生存率，治疗安全性良好。

ObjectiveTo explore the clinical effects and adverse reactions of chemotherapy combined with apatinib and intensity-modulated radiotherapy in the treatment of elderly patients with advanced cervical cancer. MethodsA total of 86 elderly patients with advanced cervical cancer who were diagnosed and treated in our hospital from January 2014 to January 2017 were selected as the research objects, and they were divided into observation group and control group by the random number method, with 43 cases in each group. The patients in the control group were given intravenous chemotherapy and apatinib, based on which the patients in the observation group were given intensity-modulated radiotherapy for treatment, with 28-day as a cycle of the treatment, and for 2 cycles of the treatment in total. The clinical efficacy and the pre- and post-treatment levels of serum squamous cell carcinoma-associated antigen (SCC-Ag) and carcinoembryonic antigen (CEA) levels, as well as the occurrence of the adverse reactions and the 1-year survival rate, 3-year survival rate were compared between the two groups. ResultsAfter the completion of the treatment courses, the clinical efficacy of the observation group was superior to that of the control group, with a statistically significant difference (P＜0.05). The SCC-Ag and CEA levels significantly decreased in both groups, and the observation group yielded lower levels in the comparison of the control group, with statistically significant differences (P＜0.05). During the treatment, there were no statistically significant differences in the occurrence of bone marrow suppression, gastrointestinal reaction, and proctitis between the two groups (P＞0.05). The 1-year and 3-year survival rates of the observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05). ConclusionChemotherapy combined with apatinib and intensity-modulated radiotherapy for the treatment of elderly patients with advanced cervical cancer can prominently improve efficacy, and effectively control the disease progression, increase the 1-year and 3-year survival rate in patients, with good treatment safety.