摘要
目的:对比局部晚期宫颈癌患者三维腔内后装放疗与二维腔内后装放疗的剂量参数与临床疗效。方法:本研究中共纳入180例宫颈癌患者,将所有患者根据放疗方法分为二维组(90例,给予常规二维腔内后装治疗)和三维组(90例,给予三维后腔内后装放疗),将两组患者治疗结束后1~3 m根据患者MRI等相关影像评估近期疗效,放疗照射剂量。结果:三维组患者临床总有效率为83.33%,相较于二维组的82.22%升高(χ^(2)=0.039,P>0.05);三维组患者小肠、膀胱、直肠的D_(2cm3)、D_(1cm3)和D0.1cm^(3)均相较于二维组下降,而靶区覆盖指数、靶区适形指数则比二维组高(t=10.175、38.279、12.399、12.861、9.019、9.222、19.601、18.247、12.669、3.729、6.548,均P<0.05);治疗后两组患者血清SCC-Ag指标水平均比治疗前低,但组间对比,未见统计学差异(t=1.017,P>0.05);三维组患者Ⅰ~Ⅲ级急性放射性膀胱炎发生率均相较于二维组下降(χ^(2)=3.972、4.709、4.709,均P<0.05);三维组患者Ⅰ~Ⅱ级急性放射性直肠炎发生率均相较于二维组下降(χ^(2)=3.894、4.490,均P<0.05)。结论:在对局部晚期宫颈癌患者进行治疗时,三维后装腔内放疗提高靶区剂量的同时降低直肠、膀胱的受量,提高肿瘤客观缓解率,有效降低不良反应发生率,安全性良好。
Objective:To compare the dose parameters and clinical efficacy of 3D intracavitary radiotherapy and 2D intracavitary radiotherapy in patients with locally advanced cervical cancer.Methods:A total of 180 patients with cervical cancer were included in this study,and all patients were divided into two groups according to radiotherapy method(90 patients received conventional 2D intracavitary posterior radiotherapy)and three group(90 patients received 3D intracavitary posterior radiotherapy).The short-term efficacy and radiation dose of patients in the two groups were evaluated based on MRI and other relevant images 1 to 3 months after treatment.Results:The total effective rate of the three-dimensional group was 83.33%,which was higher than that of the two-dimensional group(82.22%)(χ^(2)=0.039,P>0.05).D_(2cm3),D_(1cm3) and D_(0.1cm3) of small intestine,bladder and rectum in 3D group were all decreased compared with those in 2D group.The target coverage index and target conformal index were higher than those of 2D group(t=10.175,38.279,12.399,12.861,9.019,9.222,19.601,18.247,12.669,3.729,6.548,all P<0.05).The level of serum SCC-Ag index in 2 groups after treatment was lower than before treatment,but there was no statistical difference between groups(t=1.017,P>0.05).The incidence of grade I toⅢacute radiation cystitis in the three-dimensional group was significantly lower than that in the two-dimensional group(χ^(2)=3.972,4.709,4.709,all P<0.05).The incidence of grade I to II acute radiation proctitis in the three-dimensional group was significantly lower than that in the two-dimensional group(χ^(2)=3.894,4.490,P<0.05).Conclusion:In the treatment of patients with locally advanced cervical cancer,three-dimensional post-capsular radiotherapy can increase the target dose,reduce the dose of rectum and bladder,improve the objective remission rate of tumor,effectively reduce the incidence of adverse reactions,and have good safety.
作者
齐晓臻
李锦巍
秦雪
周学志
Qi Xiao-zhen;Li Jin-wei;Qin Xue;Zhou Xue-zhi(College of Medical Engineering,Xinxiang Medical College,Xinxiang 453003,Henan,China;Department of Gynecologic Oncology,Luohe Central Hospital,Luohe 462000,Henan,China)
基金
漯河医学高等专科学校2021年度创新创业发展能力提升工程科研类项目(编号:2021LYZKJXM045)。
关键词
宫颈癌
三维后装放疗
二维后装放疗
剂量参数
Cervical cancer
Three-dimensional posterior radiotherapy
Two-dimensional post-loading radiotherapy
Dose parameter
