中晚期宫颈癌CT引导下三维插植高剂量率后装近距离放疗的临床价值  

Clinical value of CT-guided high-dose-rate interstitial brachytherapy for advanced cervical carcinoma

作　　者：李小文[1] 穆娅斯尔.吐尔干 阿依努尔.买买提 古力米热.布然江 霍雯[1] 

机构地区：[1]新疆医科大学附属肿瘤医院妇科放疗二病区,乌鲁木齐830011

出　　处：《浙江医学》2016年第8期551-554,共4页Zhejiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金资助项目(2012211A047)

摘　　要：目的探讨CT引导下三维插植高剂量率后装近距离放疗(HDR-ISBT)在治疗中晚期宫颈癌中的临床价值。方法以2011年12月1日至2014年12月30日收治的175例中晚期宫颈癌患者为研究对象,其中100例行体外三维适形调强放疗(IMRT)+HDR-ISBT(A组),75例行IMRT+常规后装近距离放疗(B组),比较两组患者的疗效与不良反应。结果近期疗效:A组完全缓解(CR)95例,部分缓解(PR)2例,稳定(SD)1例,进展(PD)2例;B组CR 55例,PR 10例,SD 4例,PD 6例。肿瘤直径≥4cm时,A组有效率为95.24%,高于B组的80.00%(P=0.026)。A组部分患者出现轻中度膀胱反应、直肠反应、骨髓毒性等近期不良反应,但均能耐受。结论当宫颈癌肿瘤直径≥4cm时,HDR-ISBT近期疗效优于常规后装近距离放疗,不良反应轻且可耐受。Objective To analysis clinical value of CT-guided high-dose-rate interstitial brachytherapy （HDR-ISBT） for advanced cervical carcinoma. Methods One hundred and seventy five patients with advanced cervical carcinoma were enrolled in the study, including 100 cases （group A） treated with CT-guided HDR-ISBT and 75 cases （group B） treated with routine brachytherapy. Results There were 95 cases of CR, 2 cases of PR, 1 case of SD and 2 case of PD in group A, and 55 cases of CR,10 cases of PR, 4 cases of SD and 6 cases of PD in group B. The difference between the two groups was significant in tumor diameter greater than or equal to 4cm （95.24% vs 80.00% adverse reactionsand marrow suppression, but tolerable P=0.026）. Some patients of group A occurred acute bladder and rectal Conclusion CT-guided HDR-ISBT is superior to routine brachytherapy for advanced cervical carcinoma with tumor diametergreater than or equal to 4cm and the adverse effects are tolerable.

关 键 词：宫颈肿瘤 插植高剂量率后装近距离放疗 CT引导 

分 类 号：R737.33[医药卫生—肿瘤]