宫颈癌术后限定骨髓剂量盆腔调强放疗的临床研究  

Clinical study of bone marrow-sparing intensity-modulated radiation therapy for postoperative cervical cancer

作　　者：张芹[1] 王晗[1] 

机构地区：[1]济宁市第一人民医院肿瘤科,272100

出　　处：《中华放射医学与防护杂志》2015年第6期441-444,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 观察宫颈癌患者术后限定骨髓剂量的盆腔调强放疗（BMS-IMRT）与非限定骨髓剂量的盆腔调强放疗（IMRT）联合化疗的近期疗效及不良反应.方法 本院宫颈癌术后患者70例,用抽签方法随机分为BMS-IMRT组34例和IMRT组36例,行盆腔外照射调强放疗联合化疗,计划靶体积剂量45 Gy分25次.BMS-IMRT组勾画骨盆并给予单独限量：骨盆V30≤50％;70例患者同期每周40 mg/m2顺铂化疗.结果 除3例因重度骨髓抑制未完成化疗外,67例患者顺利完成治疗.两组2年的局部控制率及生存率、下消化道及泌尿系统不良反应差异无统计学意义,BMS-IMRT组血液学不良反应较IMRT组轻,差异有统计学意义（x2=14.355,P＜0.05）.结论 宫颈癌术后行盆腔同步放化疗患者,BMS-IMRT组较IMRT组血液学不良反应减轻,近期疗效及其他放疗不良反应无明显差异.Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy （BMS-IMRT） for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group：the pelvis V30 ≤ 50%.All cases received chemotherapy with cisplatin （40 mg/m2） once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival（LCS）and overall survival（OS）,alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference （x2 =14.355,P 〈 0.05）.Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

关 键 词：宫颈癌 限定骨髓剂量 调强放疗 不良反应 

分 类 号：R737.33[医药卫生—肿瘤] R730.55[医药卫生—临床医学]