宫颈癌盆腔淋巴结转移根治性放疗的疗效  

Study of Radiotherapy in the Treatment of Cervical Cancer with Pelvic Lymph Node Metastases

作　　者：李慧灵[1] 林娴[1] 吴宏清[1] 倪晓雷[1] 张秀春[1] 陈美英[1] 潘建基[1] 

机构地区：[1]福建医科大学教学医院福建省肿瘤医院,350014

出　　处：《实用癌症杂志》2013年第1期77-79,共3页The Practical Journal of Cancer

摘　　要：目的探讨宫颈癌盆腔淋巴结转移根治性放疗的疗效和不良反应。方法对48例盆腔淋巴结转移的宫颈癌患者行根治性放疗,44例同时辅助全身化疗。采用6～18 MVX射线前后对穿两野或前后对穿两野+左右侧野的四野照射,全盆腔照射DT30～40 Gy后中间铅挡加量DT10～20 Gy,使B点DT达50 Gy。盆腔转移的淋巴结局部小野补量(RT)照射,每次DT2 Gy,总DT8～10 Gy,高剂量后装治疗(HDR)采用核通后装机治疗,192Ir治疗,选取A点参考点,处方剂量为600～700 cGy,每周1次,共6次。结果随访时间为22～43个月,中位随访时间31个月,随访率100.00%。PR、CR分别达100.00%和83.33%(40/48),盆腔转移淋巴结完全有效率为85.42%(41/48)。结论盆腔转移淋巴结照射剂量达60 Gy以上,疗效好,无严重消化道不良反应发生。Objective To evaluate the efficacy and toxicities of radiotherapy in the treatment of cervix carcinomas with pelvic lymph node metastases.Methods From May.2008 to May.2010,48 patients with histologically proved cervix cancer were selected.44 were squamous carcinoma,3 were adenocarcinoma,1was adenosquamous carcinoma.According to the FIGO system,2 cases were stage Ⅱa,12cases Ⅱb,4 cases Ⅲa,30 cases Ⅲb.44 cases combinded with chemotherapy.All of the patients began with conventional fractionated radiotherapy by 6-18MVX-ray to a total dose of DT30-40 Gy in 3 to 4 weeks,followed by center shielding to DT 10-20 Gy.which made point B to DT 50 Gy.Patients with pelvic lymph nodes metestases got boost to DT58-60 Gy.HDR was performed weekly and concurrently with the centrally shieded EBRT.5-7 sessions were applied in the process of the brachytherapy.Results All patients completed the treatment planning with a mean followed-up of 31 months.CR was 83.33%（40/48）and PR was 100.00%（48/48）,29 patients developed gradeⅡto Ⅲ gastrointestinal reaction.3 patients got rectal bleeding,No patients developed sigmoind and rectal ulcers.Conclusion Radiotherapy could give favorable local control for cervix carcinomas with pelvic lymph node metastases.

关 键 词：宫颈癌 放射治疗 盆腔转移淋巴结 照射剂量 

分 类 号：R737.33[医药卫生—肿瘤]