中晚期子宫颈癌低氧放疗并化疗的临床效果  

CLINICAL EFFECT OF HYPOXIA-RADIOTHERAPY PLUS CHEMOTHERAPY ON PATIENTS WITH INTERMEDIATE AND ADVANCED-STAGE CERVICAL CARCINOMA

作　　者：苏岩 安永恒[2] 丁爱萍[2] 程熙国[2] 冯辉 

机构地区：[1]日照市妇幼保健院,山东日照276826 [2]青岛大学医学院附属医院肿瘤中心

出　　处：《齐鲁医学杂志》2006年第5期386-388,共3页Medical Journal of Qilu

摘　　要：目的通过对中晚期子宫颈癌病人行低氧放疗加化疗，探讨其对具有造血与免疫功能的骨髓及腹盆部淋巴等正常组织的保护作用及其与病人远期生存的关系。方法67例子宫颈癌病人均经病理证实。将其按期别不同分层随机分为低氧放疗组（低氧组，34例）和常规放疗组（对照组，33例）。低氧组病人在实施放疗前1～2min内开始吸入含氧体积分数为0．105的低氧气体，持续至该野照射完毕，每野连续照射不大于5min，换野时重复上述过程。对照组为常规放疗。两组肿瘤依期别不同给予全盆中平面剂量（Dt20～50Gy）照射，宫旁四分野中平面剂量（Dt15～34Gy）照射。两组放疗后给予MOB或FP方案全身化疗。结果低氧组治疗后外周血白细胞下降平均值为（1．49±0．51）×10^9／L，对照组为（2．86±0．78）×10^9／L，两组比较差异有显著意义（t=2．34，P〈0．05）；低氧组治疗后E花环上升（5．57±1．85）％，LC转化率上升（3．53±1．23）％，而对照组分别下降（3．35±1．67）％和（4．32±1．52）％，两组比较差异有显著性（t=5．15、2．43，P〈0．01）；两组5年生存率比较差异有显著性（X^2=4．65，P〈0．05）；两组放射性直肠炎和放射性膀胱炎的发生率比较差异也有显著性（X^2=6．75、3．98，P〈0．01、0．05）。结论对中晚期子宫颈癌病人采取低氧放疗加化疗可明显保护其骨髓的造血及细胞免疫功能，改善病人的生存质量，提高病人远期生存率，具有重要临床价值。Objective To investigate the relationship between long-term survival and protection of the marrow and lymphoid tissues in pelvis through hypoxic radiotherapy plus chemotherapy for patients with intermediate- and advanced-stage cervical carcinoma. Methods This study consisted of 67 patients whose diagnosis was confirmed pathologically. They were divided into two groups at stratified random： hypoxic radiotherapy group （HRG） and conventional radiotherapy group （CRG）. The patients in HRG inhaled hypoxic gas （oxygen physical volume： 0. 105） for two minutes before radiotherapy till the end of the treatment of each field and then repeated. The duration of irradiation to each field was less than five minutes. The patients in the control group （CRG） were only treated with conventional radiotherapy. The irradiation dose in the midpelvic plane was 20--50 Gy depending on the different stages of the cancer. The dose of four-divided-field loaded in lateral cervix was 15--34 Gy. The dose at point A of intracavitary therapy was 15--34 Gy. After the radiation mentioned above, the chemotherapy of MOB or FP regimen was gi- ven to the patients of both groups. Results The decreased value of peripheral blood white cells after treatment was （1.49 ± 0.51） × 10^9/L in HRG and （2.86±0.78） × 10^9/L in CRG, respectively （t=2.34, P〈0. 05） ; the changes of cellular immune functions before and after treatment were that the value of E flower ring test （EFRT） was increased by （5.57 ± 1.85）% and the value of lymphocyte transformation rate （LTR） was increased by （3.53 ± 1.23）% in HRG; but in CGR decreased by （ 3.35 ± 1.67） % and （4.32 ± 1.52） %, respectively （t = 5.15,2.43 ; P〈 0. 01）. The five-year survival rate was 64.9 % in HRG and 57.1 in CRG, respectively （X^2 =4. 65, P〈0.05）. The incidence of complications such as radiation proctitis and radiocystitis was also of significant difference （X^2 =6.75,3.98; P〈0. 01,0. 05）. Conclusion The hypoxic radiotherapy plus

关 键 词：宫颈肿瘤 缺氧 放射疗法 药物疗法 免疫测定 治疗结果 

分 类 号：R737.33[医药卫生—肿瘤]