^(252)锎中子后装在宫颈癌术前辅助放疗中的作用  

Efficacy of Preoperative Adjuvant Radiotherapy on Cervical Cancer with 252-Californium Neutron

作　　者：杨越波[1] 叶青剑[1] 曾海涛[1] 李贞仑 柯佩琪[3] 

机构地区：[1]中山大学附属第三医院妇产科,广东广州510630 [2]广州武警医院放射科,广东广州510507 [3]中山大学附属第一医院妇产科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2011年第5期644-647,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2010B0316000332006B36002027)

摘　　要：【目的】研究252锎中子腔内后装在宫颈癌术前辅助放疗中的作用。【方法】收集2003年01月至2010年04月中山大学附属第三医院、中山大学附属第一医院妇科收治的Ⅰb2～Ⅱb期的54例宫颈癌,分为两组,其中252锎组24例,为局部肿块直径≥4 cm,术前采用252锎中子腔内后装放疗;直接手术组30例,为局部肿块直径<4 cm,未行术前辅助治疗,直接行宫颈癌根治术。观察252锎组放疗前后肿瘤局部变化及放射性副反应,并比较252锎组与直接手术组术中情况。【结果】252锎组放疗前肿瘤平均直径46.29(S=6.28)mm,放疗后肿瘤平均直径18.63(S=9.46)mm,两者比较,差异有统计学意义(P<0.05);252锎组放疗后骨髓抑制3例(12.5%),放射性直肠炎1例(4.2%),放射性膀胱炎2例(8.3%),无严重的放射性损伤发生。252锎组平均手术时间258(S=45)min,与直接手术组266(S=60)min相比,其差异无统计学意义(P>0.05);252锎组术中平均出血量为462(S=166)mL,与直接手术组667(S=381)mL相比出血量明显减少,差异有统计学意义(P<0.05)。【结论】252锎中子腔内后装在宫颈癌术前辅助放疗中可缩小局部肿瘤、改善手术条件,且并发症少,有较好的临床使用前景。【Objective】 To evaluate the role of preoperative adjuvant radiotherapy with 252-Californium neutron on cervical cancer.【Methods】 Forty-five patients with cervical cancer in stage Ⅰb2-Ⅱb were chosen in the Third Affiliated Hospital and the First Affiliated Hospital of Sun Yat-sen University from January 2003 to April 2010.They were divided into two groups： the preoperative radiotherapy group and the non-preoperative radiotherapy group.The patients in the preoperative radiotherapy group（252-Cf group,24 cases） whose tumors were equal to or larger than 4 cm in diameter were received preoperative adjuvant radiotherapy.Thirty cases whose tumor diameters were less than 4 cm were directly received the radical hysterectomy without preoperative adjuvant therapy.The local tumor remission and radiation side effects of the 252-Cf group were observed,and the surgical findings were compared in the two groups.【Results】 The average diameter of tumors after radiation was（18.63 ± 9.46） mm,which was significantly decreased than that before radiation 46.29（S = 6.28） mm,P 0.05.The incidences of complications were quite low including 3 bone marrow suppression（12.5%）,1 radiation proctitis（4.2%） and 2 radiation cystitis（8.3%）.The mean operative time of the 252-Cf group 258（S = 44.63） min was slightly less than that of the direct surgery group 266（S = 60） min,and there was no significant difference（P 0.05）.The average blood loss of the 252-Cf group 462（S = 166） mL was less than that of the direct surgery group 667（S = 381） mL,and the difference in two groups was significant（P 0.05）.【Conclusion】 The preoperative adjuvant radiotherapy with proper dose before radical hysterectomy can reduce the size of tumors with low side-effects and be benefit to the operations.It is a promising method in the treatment of cervical cancer.

关 键 词：252锎 宫颈癌 术前辅助放疗 

分 类 号：R737.33[医药卫生—肿瘤]