^(252)锎后装放疗联合三维适形放疗治疗宫颈癌的安全性研究  

Study on the Safety of 252-Californium Brachytherapy with Three-dimensional Conformal Radiotherapy for Cervical Cancer

作　　者：赖淑贞[1] 廖卫坚[1] 余晓文[1] 封红胜[1] 陈志仁[1] 

机构地区：[1]汕头大学附属粤北人民医院肿瘤中心,广东省韶关市512026

出　　处：《医学理论与实践》2014年第10期1265-1266,1271,共3页The Journal of Medical Theory and Practice

基　　金：广东省韶关市医药卫生科研计划项目(编号Y11007);广东省韶关市科技局立项〔编号韶科(卫)2011-16〕

摘　　要：目的:观察252锎腔内后装治疗联合盆腔三维适形放疗治疗宫颈癌的直肠、膀胱并发症,对治疗方案进行安全性评价。方法:收集2011年1月-2012年12月宫颈癌病例共89例,采用252锎中子腔内后装治疗和盆腔三维适形放疗同时进行的方法进行治疗。其中,252锎中子腔内后装治疗,宫旁A点剂量为6~7Gy/次,1次/周,共进行6~7次,使宫旁A点累积剂量达35~42Gy;盆腔外照射采用三维适形放疗,总剂量46~50Gy;A点全程总剂量达70Gy以上,治疗计划中直肠累积最大受量<60Gy。结果:急性放射性膀胱损伤率为9.0%(8/89),急性放射性直肠损伤率为15.7%(14/89),1例患者出现RTOG 3级晚期放射性直肠反应及RTOG 2级晚期放射性膀胱反应。结论:252锎中子腔内放射治疗联合盆腔三维适形放疗治疗宫颈癌,在严格限制直肠累积受照剂量的条件下,合理提高A点照射剂量,并发症少。Objective：The aim of the study was to investigate the radiation complications of rectum and bladder during 252-Californium brachytherapy with three-dimensional conformal radiotherapy for cervical cancer.Methods：89patients with cervical cancer treated by radical radiation therapy between January 2011and December 2012were included in this study.252-Californium neutron brachytherapy and external radiation were performed sequentially.252-Califorium neutron brachytherapy was performed with one fraction of 6～7Gy dose at reference A point every week and the total dose at A point was 30～42Gy.The whole pelvis was treated with three-dimensional conformal radiotherapy with total dose 46～50Gy.The total radiation dose at A point from both external beam and 252-Californium was over 70Gy.The maximum dose of the rectum was less than 60Gy.Results：The acute radiation complications of bladder and rectum were 9% and 15.7% respectively.The late radiation complications in rectum of grades 3（according to the RTOG/EORTC standard）only observed in one case.Conclusion：252-Combination the Californium brachytherapy with external three-dimensional conformal radiotherapy can be well tolerated by cervical cancer patients when the maximum dose of the rectum was less than 60Gy.

关 键 词：子宫颈癌 252锎 放射治疗 三维适形放疗 

分 类 号：R737.3[医药卫生—肿瘤]