同步热放化疗治疗中晚期宫颈癌的近期疗效观察  

Observation on short term effects of concurrent hyperthermia and radiochemotherapy in treatment for medium-term and advanced cervical cancer

作　　者：高琨[1] 张彩红[1] 陈心秋[1] 李力[1] 

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科,南宁530021

出　　处：《重庆医学》2013年第7期736-738,共3页Chongqing medicine

基　　金：广西卫生厅科研基金资助项目(Z2002188)

摘　　要：目的探讨同步热放化疗在Ⅱb～Ⅲb期宫颈癌治疗中的疗效及安全性。方法选择2005年11月至2007年10月广西医科大学附属肿瘤医院住院治疗的经病理检查确诊为Ⅱb～Ⅲb期的宫颈癌患者118例,随机分两组:单纯放疗组38例,外照射放疗采用常规分割全盆野体外照射,每天1次1.8Gy,5次/周;DT 30.6Gy后中央挡铅(4～5)cm×(10～11)cm,DT 14.4Gy。外照射总量为45～50.4Gy。DT 27Gy时加行腔内照射,1次/周,A点剂量42～49Gy。同步放化疗组44例,放疗方法同单纯放疗组,在放疗同时行化疗,每周DDP 40mg.m-2,共6周期。热疗加同步放化疗组36例,放化疗方法同同步放化疗组,化疗当天同时行盆腹腔深部局部热疗,体心温度维持41.8～42℃,持续60min,1次/周,共4次。比较3组患者治疗近期疗效。结果热疗加同步放化疗组、同步放化疗组和单纯放疗组外照射45Gy时局部肿瘤完全消退率分别为66.7%、40.9%和18.4%(P<0.05)。结论同步热放化疗治疗中晚期宫颈癌能促进局部肿瘤消退,提高完全缓解率,安全可耐受。Objective To explore the efficacy and safety of concurrent hyperthermia and radiochemotherapy in the treatment of stage Ⅱ b-- Ⅲ b cervical cancer. Methods 118 patients with stage Ⅱ b--Ⅲ b cervical cancer diagnosed by pathology in this hospital from November 2005 to October 2007 were selected and randomly divided into 3 groups. The simple radiotherapy group（RT,38 ca- ses） adopted the conventional segmentation whole pelvic field external exposure, once daily, 1.8 Gy, 5 times a week;DT 30. 6 Gy postcentral crosspiece lead（4--5）cm × （10--11）cm, DT 14.4 Gy. The total external exposure was 45- 50.4 Gy. In DT 27 Gy, the internal exposure was added,once a week,with the point A dose of 42--49 Gy. The concurrent radiochemotherapy group（CRT, 44 cases） had the same radiotherapy to the RT group and simultaneously received the chemotherapy,DDP 40 mg/m2/week, for 6 cy- cles. The concurrent hyperthermia and radiochemotherapy group（H＋CRT,36 cases） had the same radiochemotherapy to the CRT group and was simultaneously performed the local hyperthermia in the deep sites of abdominopelvic cavity,maintaining the body- centered temperature of 41.8--42 ℃ for 60 rain, once a week, for 4 times. The short-term effieacies were observed among 3 groups. Results The complete extinction rates of local tumor after external exposure 45 Gy in the H＋CRT,CRT and RT groups were 66.70% ,40.9% and 18.4% respectively（P〈0.05）. Conclusion Concurrent hyperthermia and radiochemotherapy in treating medi- um-term and advanced cervical cancer may promote the regression of local tumor, increase the remission rate and is completely toler- able.

关 键 词：宫颈肿瘤 热疗 放射治疗 化学治疗 

分 类 号：R737.33[医药卫生—肿瘤]