摘要
探讨全盆四野加速超分割放射治疗晚期子宫颈癌的临床价值。方法:于1998年1月至1999年10月分别采用全盆二野常规分割标准方案(CF组,18例)和全盆四野加速超分割方案(AHF组,17例),治疗Ⅲb期子宫颈鳞癌,对放射不良反应和治疗效果进行临床比较研究。结果:1)AHF组全疗程平均40.1天完成,CF组平均57.3天完成,AHF组疗程显著短于CF组(P<0.01);2)AHF组2、3年生存率分别为88.2%、82.4%,CF组分别为83.3%、72.2%,前者有提高生存率的趋势,但差异无统计学意义(P>0.05);3)AHF组3年局部控制率(94.1%)高于CF组(77.8%),AHF组有提高肿瘤局部控制率的趋势,但两组差异无统计学意义(P>0.05);4)近期放疗反应两组第一位均为直肠反应,其次是膀胱反应,差异无统计学意义(P>0.05);远期放疗反应第一位为照射野皮下纤维化,AHF组发生率(5.9%)显著低于CF组(72.2%)(P<0.01),两组直肠、膀胱反应发生率差异均无统计学意义(P>0.05)。结论:当采用60Co体外照射时,全盆四野加速超分割方案与常规分割标准方案比较,有提高ⅢΒ期子宫颈鳞癌生存率及局部控制率的趋势,具有总疗程明显缩短,不增加近期放疗不良反应,可显著减少远期照射野皮下纤维化的发生等优点,值得推广。
Objective:To learn the clinical value of the whole pelvic BOX field and ac-celerated hyperfractionated radiation therapy protocol(AHF)in the treatment of advanced cervical cancer.Methods:From Jan.1998to Oct.1999,the patients of squamous cervical cancer in stageⅢb were treated in our hospital by the whole pelvic2fields,conventionally fractionated protocol(CF group,n=18)and the whole pelvic BOX field,accelerated hyperfractionated radiation therapy protocol(AHF group,n=17)separately.Results:1.Average treatment course was40.1days in AHF group,and57.3days in CF group,the former was extremely significant shorter than the lat-ter(P<0.01).2.The2and3years survival rate of AHF group were88.2%,82.4%,and83.3%,72.2%in CF group.No significant differences were found between these two groups(P>0.05).3.The local control rate of AHF group were94.1%,and77.8%in CF group.No significant differ-ences were found between these two groups(P>0.05).4.Among the acute side reaction,rectum re- action listed the firstin both AHF and CF groups,and bladder reaction the second,no sig nifi cant differences were found between them of the two groups (P>0.05).The first reaction of the late side reaction was dermofibrosis within the external radi ation field.It happened only in5.9%cases of AHF group,but 72.2%of CF group,the former was extremely significant lower than the later(P<0.01).There were no significant differences of the rectum and bladder late reaction between these two groups(P>0.05).Conclusions:Comparing with CF group,the whole pelvic BOX field and accelerated hyperfraction protocol tend to improve survival rate and local control rate of the advanced squamous cervical cancer,meanwhile,it could shortening the treatment course obviously,decreasing the dermofibrosis significantly.It's recommended that when using 60 Co as the radia-tion source,this technique should be used better.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2003年第8期547-550,共4页
Chinese Journal of Clinical Oncology
基金
国际原子能机构科研基金资助
关键词
子宫颈癌
加速超分割
放射治疗
Cervical cancer Accelerated hyperfraction protocol Radiation therapy
