盆腔体外联合腔内放射治疗宫颈癌72例的临床疗效分析  

Clinical Analyses of External Radiotherapy Combined with Brachytherapy in the Treatment of Patients with Cervical Cancer

作　　者：于海英[1] 薛忠伟[1] 高绍英[1] 

机构地区：[1]烟台市莱阳中心医院肿瘤一科,265200

出　　处：《实用癌症杂志》2011年第2期158-160,163,共4页The Practical Journal of Cancer

摘　　要：目的探讨盆腔体外联合腔内放射治疗宫颈癌的疗效、不良反应及预后影响因素。方法对72例初治Ⅰ～Ⅳ期宫颈癌患者,应用6-MVX线全盆前后对穿照射,4 000～5 000 cGy,体外放疗3～4次/周,每次180～200 cGy;宫腔内放疗3 000～4 000 cGy,阴道腔内放疗3 000～4 500 cGy1,～2次/周,每次300～700 cGy,宫腔与阴道腔内治疗交替进行。结果盆腔体外联合腔内放射治疗宫颈癌的近期有效率是98.6%,5年总生存率为54.1%,其中Ⅱ期患者5年生存率为75.0%,Ⅲ期患者5年生存率为41.4%,影响宫颈癌近期疗效的主要因素是肿瘤大小。肿瘤病理类型、大小、临床分期及近期疗效是影响宫颈癌预后的因素。常见的不良反应为放射性直肠炎、放射性膀胱炎及骨髓抑制。结论盆腔体外联合腔内放射治疗宫颈癌,能提高肿瘤局部控制率,但不能有效控制肿瘤全身转移。Objective To evaluate the efficacy,adverse effects and prognosis factors of patients with cervical cancer treated by external radiotherapy combined with brachytherapy.Methods 72 patients with newly diagnosed cervical cancer were treated by radiotherapy which included external radiotherapy of 4 000~5 000 cGy,3~4 fractions each weeks in 180~200 cGy per fraction,to the whole pelvic cavity by 6 MV X-rays followed by alternative brachytherapy of 3 000~4 000 cGy to the uterine cavity and 3 000~4 500 cGy to the vaginal cavity in 1~2 times each week,and 300~700 cGy each time.Results The immediate effective rate was 98.6%,and the 5 year overall survival rate was 54.1%.The 5 year survival rate of stage Ⅱ and stage Ⅲ were 75.0% and 41.4%,respectively.Tumor size was the most important factor to influence the immediate efficacy.Clinical stage,tumor size,pathologic type and immediate effects can influence the prognosis of cervical cancer.The adverse reactions included radiation induced rectitis,radiation induced cystitis,and hematological toxicities.Conclusion The external radiotherapy combined with brachytherapy can improve local control rate,but can not effectively control tumor metastasis of patients with cervical cancer.

关 键 词：宫颈癌 外照射 后装腔内放疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤]