Abstract: Background　Some studies suggested that low-differentiation effected the prognosis of patients after radical hysterectomy ofcervical cancer,but there was no evidence whether such patients demonded the adjuvant therapy.Objective　To evaluate the effect of adjuvant therapy on prognosis of early simply low-differentiation cervical squamous cell carcinoma.Methods　A total of 103 patients of early simply low-differentiation cervical squamous cell carcinoma in Xinjiang Medical University Affiliated Tumor Hospital from 2002 to 2011 were enrolled for the retrospective analysis.The patients were divided into adjuvant therapy troup （surgery+adjuvant therapy,n=40） and control group （surgery alone,n=63）.We recorded and compared the two groups’ general data,surgery,adjuvant therapy,postoperative complications,side-effects of radiotherapy/chemotherapy,recurrence and survival time.Results　There was no significant difference between the two groups in operative time,dissected lymph nodes and bleeding during operation （P>0.05）.In adjuvant therapy group,2 of 17 cases accepted radiotherapy alone relapsed and 1 died;1 of 10 cases accepted chemotherapy alone relapsed and died;There were no recurrence and metastases in 13 cases accepted chemoradiotherapy and radiotherapy.There was no significant difference between the two groups in postoperative complications （P>0.05）.In adjuvant therapy group,the top three side effects of radiotherapy were:radiation enteritis （25.0%,10/40）,myelosupression （37.5%,15/40） and radiocystitis （5.0%,2/40）;the top three side effects of chemotherapy were:myelosupression （32.5%,13/40）,gastrointestinal reaction （25.0%,10/40）,abnormal hepatic function （5.0%,2/40）.2 patients refused the last intracavitary radiotherapy because of the heavy radiation enteritis.There were no patients discontinued adjuvant chemotherapy because of side effects,no patients died of side effects of radiotherapy/chemotherapy.The reccurence rate in control group was significantly higher than that in adjuvant therapy group （χ2=5.209,P=0.023）.The mortality in control group was significantly higher than that in adjuvant therapy group （χ2=4.111,P=0.043）.The tumor-free survival rate in control group was significantly lower than that in adjuvant control group （P<0.05）.The overall survival rate in control group was significantly lower than that in adjuvant therapy group （P<0.05）.Conclusion　Adjuvant therapy after operation was feasible for the patients with simply low-differentiation cervical squamous cell carcinoma of stage Ⅰ to Ⅱ.The side effects of adjuvant therapy can be reversed by symptomatic treatment,and the patients can tolerate and get better short and long term curative efficacy.

Key words: Uterine cervical neoplasms, Chemoradiotherapy,adjuvant, Low differentiation, Prognosis

摘要： 背景　部分学者认为，低分化影响宫颈癌根治术后患者的预后，但该类患者是否应行术后辅助治疗存在争议。目的　探讨术后辅助治疗对早期单纯低分化宫颈鳞癌患者预后的影响。方法　回顾性分析2002—2011年新疆医科大学附属肿瘤医院收治的103例早期单纯低分化宫颈鳞癌手术患者的临床资料。根据治疗方式，将患者分为辅助治疗组（手术+辅助治疗，40例）和对照组（单纯手术，63例）。记录并比较患者一般资料、手术情况、辅助治疗情况、术后并发症发生情况、放/化疗毒副作用、复发及生存情况。结果　两组手术时间、盆腔淋巴结清扫数量、术中出血量比较，差异无统计学意义（P>0.05）。辅助治疗组术后单纯放疗患者17例，其中2例复发，1例死亡；术后单纯化疗患者10例，其中1例复发并死亡；术后放、化疗患者13例，随访期内未发现复发及转移征象。两组术后并发症发生率比较，差异无统计学意义（P>0.05）。辅助治疗组放疗毒副作用发生率前3位分别为放射性肠炎（25.0%，10/40）、骨髓抑制（37.5%，15/40）、放射性膀胱炎（5.0%，2/40），化疗毒副作用发生率前3位分别为骨髓抑制（32.5%，13/40）、胃肠道反应（25.0%，10/40）、肝功能损害（5.0%，2/40）；2例患者因无法忍受放射性肠炎拒绝行最后1次腔内治疗，无一例患者因化疗毒副作用而中止治疗；无一例患者因放/化疗毒副作用而死亡。对照组复发率高于辅助治疗组（χ2=5.209，P=0.023）。对照组病死率高于辅助治疗组（χ2=4.111，P=0.043）。对照组无瘤生存率低于辅助治疗组（P<0.05）；对照组总生存率低于辅助治疗组（P<0.05）。结论　对Ⅰ~Ⅱ期单纯低分化宫颈鳞癌患者术后行辅助治疗是一种可行的方法，且辅助治疗的毒副作用经对症处理后均可逆转，患者可以耐受并获得较好的近、远期疗效。

关键词: 宫颈肿瘤, 放化疗,辅助, 低分化, 预后