中晚期宫颈癌^(252)Cf中子腔内后装加盆腔外照射同期化疗的近期疗效分析  

Observation of short-term of ^(252)Cf neutron intracavitary brachytherapy combined with chemoradiotherapy in treatment of advanced cervical cancer

作　　者：徐晓南[1] 张群功[1] 陈志仁[1] 刘洪波[1] 黄利萍[1] 

机构地区：[1]汕头大学附属粤北人民医院肿瘤中心,广东韶关512026

出　　处：《中华肿瘤防治杂志》2012年第2期146-148,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了观察同步放化疗对中晚期宫颈癌近期临床疗效,对28例未接受过任何治疗的ⅡB～ⅣA期宫颈癌患者行252 Cf中子腔内后装加盆腔外照射同期化疗。化疗采用顺铂(DDP)30 mg,d1～d5静脉推注,5-氟尿嘧啶(5-FU)750mg,d1～d5静脉滴入,21～28d为1个周期,共用2个周期;1个周期化疗结束后2d开始采用直线加速器体外放疗,盆腔前后左右4野盒式照射,2Gy/(次.d),4次/周,组织量达30～36Gy后,盆腔野中央屏蔽挡铅4cm×10cm,继续盆腔前后2野照射,使盆腔外照射剂量达46～50Gy;期间配合252 Cf中子腔内后装治疗,宫旁A点剂量为(7～10)Gy/次,1次/周,共进行4～5次,使宫旁A点剂量达36～40Gy,中子腔内后装治疗单日不行外照射治疗。近期疗效,所有病例在治疗结束后3个月复查盆腔MR结果示仅3例未控,其余皆达到CR,1和2年生存率分别为89.28%和85.71%,主要不良反应为放射性直肠炎、放射性膀胱炎和消化道反应和骨髓抑制,以轻度为主,经处理后可恢复,无严重不良反应。初步研究结果提示,252 Cf中子腔内后装加常规外照射同期化疗治疗中晚期宫颈癌,可提高局控,不良反应可耐受,应做为中晚期宫颈癌的主要治疗手段,但长期疗效及晚期反应还需进一步观察。The objective of this study was to evaluate the treatment of advanced cervical cancer with californium-252（252Cf） brachytherapy combined with chemoradiotherapy.Totally 28 cases of cervical cancers who had not received any treatment were diagnosed as in the stages ⅡB-ⅣA according to the criteria of FIGO.Chemotherapy ：cisplatin（DDP） 30 mg,d1-d5,iv,and fluorouracil（5-FU） 750 mg,d1-d5,ivdrip,21-28 days as one cycle,totally 2 cycles.252Cf brachytherapy,7-10 Gy/f,every week,the total dose of reference point A was 36-40 Gy in three to four implant sessions.On the second day after 252Cf therapy,the whole pelvis was treated with X-ray external beam radiotherapy,2 Gy/f,4 times very week.The total dose of external beam radiotherapywas 46 to 50 Gy（the middle of pelvis was shielded with 4 cm×10 cm of lead）.The recent therapeuticeffect and complications were observed.Three cases of illness were progressive disease.The others were complete remission.The 1 and 2 year survival rate was 89.28% and 85.71%.The late radioactive complications of bladder and rectum was low.In conclusion,combined 252Cf brachytherapy and high energy X-ray external beam radiotherapy may be safe and effective on advanced cervical cancer.

关 键 词：宫颈肿瘤 锎中子 放射治疗剂量 近距离放疗 

分 类 号：R737.33[医药卫生—肿瘤]