三维适形放射治疗技术治疗复发性宫颈癌的短期疗效评估  

Curative effect of 3-dimensional conformal radiotherapy for recurrence cervix cancer:report of 42 cases

作　　者：唐郢[1] 周琦[1] 舒小蕾[1] 刘俐[1] 

机构地区：[1]重庆市肿瘤研究所妇瘤科,重庆400030

出　　处：《第三军医大学学报》2009年第17期1682-1684,共3页Journal of Third Military Medical University

基　　金：重庆市卫生局基金(03-2-006)~~

摘　　要：目的探讨三维适形放射治疗技术(3-dimensional conformal radiotherapy,3D-CRT)对复发性宫颈癌的临床疗效。方法收集我院2004年4月至2007年12月间实施三维适形放疗及同步化疗的复发性宫颈癌病例共42例作为观察组,并以同期采用盆腔前后野照射及同步化疗的复发性宫颈癌病例共34例作为对照组。判断2组治疗疗效和急性放射毒副反应。结果观察组完成外照射肿瘤处方剂量(DT)(45.0±7.3)Gy,对照组完成外照射肿瘤处方剂量(37.0±4.5)Gy,2组之间没有统计学差异(P>0.05);观察组局部控制率52.38%(22/42),对照组为32.35%(11/34),两组间有统计学差异(P<0.05);通过生存曲线分析,观察组中位生存时间18.13个月,显著高于对照组的12.53个月(P<0.01);观察组1例发生膀胱阴道瘘,2例出现直肠阴道瘘,12例出现Ⅲ度以上骨髓抑制。对照组8例出现Ⅲ度以上骨髓抑制,2例发生膀胱阴道瘘。结论三维适形放疗技术用于复发性宫颈癌的治疗的疗效优于盆腔前后野照射,不增加放射副反应。Objectives To assess the feasibility of 3-dimensional conformal radiotherapy （3D-CRT） for recurrence cervix cancer. Methods Totally 42 patients with recurrence cervix cancer who were admitted in our institute from April 2004 to December 2007 and treated with 3D-CRT and conventional external radiation therapy were retrospectively studied. These 42 patients treated with 3D-CRT was group A. The other 34 matched patients treated with anterior posterior field radiotherapy at the same time period was group B. Preliminary outcome and toxicity were evaluated in the 2 group. Results All patients completed the prescribed dose. Group A was （45.00 ±7.31 ） Gy and group B was （37.00 ± 4.53 ） Gy. There was no significant difference in the 2 groups （P 〉0.05）. The effective rate of group A was 52.38% （22/42）, and group B was 32.35% （11/34）. There was significant differences between the 2 groups （ P 〈 0. 05 ）. The survival curve showed that the average survival time of group A was 18.13 months, and that of group B was 12.53 months. There was significant difference between the 2 groups （P 〈0.01）. In group A, acute grade ≥3 myelotoxicity were seen in 12 patients. One patient had vesicovaginal fistula. Two patients had rectovaginal fistula. In group B, acute grade ≥ myelotoxieity were seen in 8 patients. Two patients had vesicovaginal fistula. Conclusion The curative effect of 3D-CRT is better than anterior posterior field radiotherapy. The acute toxicity of 3D-CRT is acceptable.

关 键 词：适形放疗 宫颈癌 前后野照射 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]