三维适形放疗联合同步化疗治疗宫颈癌放疗后复发的临床观察  

Conformal Radiotherapy Combined with Concurrent Chemotherapy for Treatment of Pelvic Recurrence Cervical Cancer after Radiotherapy

作　　者：黄一统[1] 王弋[1] 柯晓慧[1] 李胡斌[1] 胡芝[1] 徐律[1] 伍其竖[1] 

机构地区：[1]温州医学院定理临床学院,浙江温州325000

出　　处：《实用妇产科杂志》2011年第6期436-438,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：评价三维适形放疗联合同步化疗,治疗宫颈癌放疗后盆腔复发的近期疗效和毒副反应。方法：2006年6月至2009年12月收治的宫颈癌放疗后盆腔复发病例23例为观察组,实施三维适形放疗及同步化疗,盆腔外照射肿瘤总量40~60Gy。并以同期采用盆腔前后野照射及同步化疗的宫颈癌放疗后盆腔复发病例共29例作为对照组,盆腔外照射肿瘤总量20~30Gy。观察两组治疗疗效和急性放射毒副反应。结果：观察组1年生存率为82.6%,有效率（CR＋PR）为87.0%,腰骶疼痛缓解率75.0%、下肢痛缓解率82.4%、下肢水肿缓解率85.7%,与对照组比较差异均有统计学意义（P〈0.05）。放射性直肠炎、放射性膀胱损伤发生率分别为17.4%、4.3%,与对照组比较差异有统计学意义（P〈0.05）。近期骨髓抑制发生率两组比较,差异无统计学意义（P〉0.05）,全部患者均可耐受。结论：三维适形放疗联合同步化疗,治疗宫颈癌放疗后盆腔复发,疗效优于盆腔前后野照射,不增加放射毒副反应。Objective：To evaluate the curative effect and side effect of three-dimensional conformal radiotherapy （3D-CRT） combined with concurrent chemotherapy on pelvic recurrence of cervical cancer after radiotherapy.Methods：23 patients with pelvic recurrence of cervical cancer after radiotherapy from June 2006 to December 2009 as study group were treated by three-dimensional conformal radiotherapy combined with concurrent chemotherapy with a total dose of 40～60Gy in pelvic external exposure.The other 29 matched patients treated by anterior posterior field radiotherapy combined with concurrent chemotherapy with a total dose of 20～30Gy in pelvic external exposure at the same time was control group.Preliminary outcome and toxicity were evaluated in two groups.Results：1-year-survival rate was 82.6% in study group.The total efficiency rate （CR＋PR） was 87.0%.The remission rates of lumbosacral pain,inferior extremity pain and leg edema were 75.0%,82.4% and 85.7% respectively.There was significant differences between two groups （P0.05）.The incidence of radiation proctitis and radioactive bladder damage was 17.4% and 4.3% respectively,which was significantly statistical difference（P0.05）.There was no significant difference in bone marrow inhibition between two groups（P0.05）.All patients were tolerated.Conclusions：The curative effect of 3D-CRT combined with concurrent chemotherapy is better than anterior posterior field radiotherapy in the treatment of pelvic recurrence of cervical cancer after radiotherapy and the side effects are not increased.

关 键 词：三维适形放疗 宫颈癌 同步化疗 

分 类 号：R737.33[医药卫生—肿瘤]