巨块型宫颈癌术前高剂量率腔内放疗近期疗效分析  

The study on the efficacy of high-dose-rate intracavitary brachytherapy prior to surgery on bulky cervical cancer

作　　者：夏红[1] 林仲秋[1] 徐燕 杨丽 陈翊 吴少雄[3] 

机构地区：[1]中山大学附属第二医院妇产科 [2]广州市番禺人民医院妇产科,广东广州511400 [3]中山大学附属肿瘤医院放疗科,广东广州510060

出　　处：《中国实用妇科与产科杂志》2006年第8期588-590,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨巨块型宫颈癌根治术前高剂量率腔内近距离放疗(ICBT)的治疗效果。方法对200001-200412中山大学附属肿瘤医院和附属第二医院收治的51例ⅠB2～ⅡB期巨块型宫颈癌根治术前采用ICBT,对患者的局部肿瘤缓解情况、毒副反应、手术情况及高危病理因素进行回顾性分析;与同期直接接受根治术的同期别56例巨块型宫颈癌比较。结果施行ICBT后,宫颈肿瘤临床完全缓解5.9%(3/51),部分缓解51.0%(26/51),无变化43.1%(22/51),恶化0。并发症发生率较低,主要是骨髓抑制、腹泻、放射性直肠炎和膀胱炎。全部患者均按宫颈癌根治术规范完成。ICBT组较直接手术组手术时间缩短(3.58±1.08)h对(4.46±0.93)h,术中出血量减少(395.1±219.8)mL对(999.1±637.4)mL,术后拔尿管时间缩短(11.47±6.48)d对(15.18±8.41)d,尿潴留的发生率减少(37.25%对48.2%)。除尿潴留外,两组比较差异均有显著性(P<0.05)。高危病理差异无显著性(P>0.05)。结论宫颈癌根治术前适当剂量腔内放疗是较早期巨块型宫颈癌较理想的治疗方案。Objective To investigate the efficacy of high-dose-rate of intracavitary brachytherapy （ICBT） followed by surgery in the bulky cervical cancer. Methods The data of 107 patients （the ICBT group and the surgical group）were reviewed respectively from Jan. 2000 to Dec. 2004. Results In the ICBT, the clinical complete remission （CR） was 5.9%, partial remission （PR） 51.0%, stable diameter （SD） 43.1% and the progression disease（ PD）0. The incidence of complication was quite low. The subsequent surgery went well. The duration of operation of them was 3.58 ± 1.08h and 4.46 ±0.93h. The blood loss was 395.1 ± 219.8ml and 999. 1 ± 637.4ml. The time of pulling-out the urinary catheter was 11.47 ±6. 48d and 15.18 ±8.41d. The incidence of urinary retention was 37.25 percent and 48. 2 percent. Except for the last, there was significant difference between them （P 〈 0. 05）. Conclusion Preoperative high-dose-rate intracavitary brachytherapy in proper dose before radical hysterectomy may reduce the tumor volume and benef operation. Radiotherapy with high-dose-rate after loading intracavitary irradiation is feasible and effective.

关 键 词：宫颈肿瘤 巨块型 放射疗法 腔内 手术治疗 

分 类 号：R71[医药卫生—妇产科学]