摘要
目的探索腔内后装治疗和体外放射治疗在子宫颈癌放射治疗中,体内外放疗剂量权重的合理分配,以提高子宫颈癌的局部控制率,减少并发症的发生率和局部复发率,提高远期生存率,为子宫颈癌的放射治疗提供更有效、更安全的模式。方法将158例Ⅱb-Ⅳa期同期放化疗的宫颈癌患者按治疗的时间分为2组:2006年1月至2007年6月,行全盆外照射50 GY/25 F,当30 GY后中央挡铅,腔内后装治疗A点50 GY的患者为挡铅组(86例);2007年7月至2008年12月,行全盆照射50 GY,中间无挡铅,腔内后装治疗A点30 GY的患者为无挡铅组(72例)。观察2组近期及远期的不良反应(放射性直肠炎、膀胱炎,直肠阴道瘘),局部复发率及1、3年的生存率。结果 2组1年生存率比较差异无统计学意义(P>0.05);3年生存率挡铅组为74.4%,无挡铅组为87.5%,2组比较差异有统计学意义(χ2=4.252,P=0.039)。放射性直肠炎挡铅组为13.9%,无挡铅组为4.2%,2组比较差异有统计学意义(χ2=4.369,P=0.037)。挡铅组放射性膀胱炎、直肠阴道瘘及局部复发率均高于无挡铅组,但2组比较差异均无统计学意义(均P>0.05)。结论无挡铅组治疗子宫颈癌的疗效较挡铅组更好,不良反应更轻,能减少放射性直肠炎、膀胱炎的发生率,减少局部复发率,提高远期生存率。
Objective To provide a more effective and safe mode for the radiation treatment of cervical cancer through exploring the reasonable radiation dose weight allocation in vitro and in vivo in intracavitary brachytherapy and external beam radiation therapy for cervical cancer to increase the local control rate, reduce complication and local recurrence rates and to improve long-term survival. Methods A total of 158 patients with stage IIb-IVa cervical carcinoma were divided into two groups according to the treatment time. Patients in lead block group （n=86） received whole pelvic irradiation to 50 GY/25 F with intracavitary brachytherapy between January 2006 and June 2007. The center of whole pelvic field was blocked after 30 GY and the point A dose was 50 GY. Patients in non-lead block group （n=72）received whole pelvic irradiation to 50 GY with intracavitary brachytherapy between July 2007 and December 2008. The center of whole pelvic field was not blocked and the point A dose was 30 GY. The short-term and long-term adverse reactions （radiation proctitis, radiation cystitis and rectovagina] fistula）,local recurrence rate and 1-3-year survival rate were compared between the two groups. Results There were no significant differences in 1-year survival rate between the two groups （P〉0.05）. Compared with non-lead block group, the 3-year survival rate significantly decreased and the incidence of radiation proctitis obviously increased in lead block group（74.4% vs 87.5% and 13.9% vs 4.2%, respectively; P〈0.05）. The incidence of radiation cystitis and reetovaginal fistula and the rate of local recurrence in lead block group were higher than those in non-lead block group, but the differences were not significant between the two gTOUps（P〉0.05）. Conclusion Compared with non-lead block group, radiotherapy of cervical cancer can reduce the incidence of radiation cystitis and proctitis, decrease local recurrence rate and improve long-term survival rate in lead block group.
出处
《实用临床医学（江西）》
CAS
2013年第3期1-3,共3页
Practical Clinical Medicine
关键词
子宫颈癌
放射治疗
后装治疗
放射性直肠炎
放射性膀胱炎
cervical cancer
radiotherapy
intracavitary brachytherapy
radiation proctitis
radiation cystitis
