容积旋转调强放疗联合同步化疗对中晚期宫颈癌的近期疗效评价  

Evaluation of short term efficacy of VMAT combined with concurrent chemotherapy in the treatment of middle stage and advanced cervical cancer

作　　者：李国强[1] 罗敬[1] 郑志坚[1] 张锦宏[2] 陈爱辉[3] 杨海坤[4] 

机构地区：[1]广东省梅州市人民医院放疗科,514000 [2]广东省梅州市人民医院化疗科,514000 [3]广东省梅州市人民医院放射治疗室科,514000 [4]广东省梅州市人民医院妇科,514000

出　　处：《白求恩医学杂志》2017年第2期141-143,共3页Journal of Bethune Medical Science

基　　金：梅州市科技计划项目(编号:2015B013)

摘　　要：目的评价采用容积旋转调强放疗(VMAT)联合同步化疗治疗中晚期宫颈癌的近期疗效及毒副反应。方法将经病理确诊的72例中晚期宫颈癌患者随机分为两组,各36例。给予对照组适形调强放疗(IMRT)联合同步化疗;给予观察组VMAT联合同步化疗;对比两组的近期疗效及毒副反应,随访生存情况。结果两组患者近期疗效比较,差异无统计学意义(P>0.05);治疗后,两组患者肿瘤均明显缩小(P<0.01),观察组患者肿瘤缩小幅度大于对照组(P<0.01)。治疗期间,观察组患者骨髓抑制发生率低于对照组(P<0.05);随访1年,两组的一年生存率、远处转移率、局部控制率及卡氏(KPS)评分对比未见显著性差异(P>0.05)。结论相较于IMRT,VMAT联合同步化疗可更好的缩小肿瘤体积,减少中晚期宫颈癌的血液毒性,具有较高的临床应用前景。Objective To evaluate the short-term efficacy and side effects of VMAT combined with concurrent chemotherapy in the treatment of middle stage and advanced cervical cancer. Methods Seventy-two patients with middle stage and advanced cervical cancer and confirmed by pathology were divided into two groups（ n = 36 each group）. The control group was treated with intensity modulated radiotherapy （IMRT） combined with concurrent chemotherapy, while the experimental group was given VMAT combined with concurrent chemotherapy. Then,the short-term efficacy and side effects and differences in survival rates during follow-ups, were compared between the two groups. Results The clinical remission rate in the experimental group was 97. 22%, higher than that of the control group（ 94.44% ）, with no significant difference （P 〉 0.05 ） ;Before treatment, there was no significant difference in tumor size between the two groups （ P 〉 0.05 ） ; After treatment, tumors in two groups were significantly reduced （ P 〈 0. 01 ）, but the reduced size of the experimental group was significantly less than that of the control group （P 〈 0. 01 ） ;there was statistically significant difference in the incidence rate of bone marrow suppression with a lower rate in the experimental group （ P 〈 0. 05 ） ; All the patients were followed up for 1 years, and there was no significant difference in the overall survival rate, distant metastasis rate,local control rate and KPS score between the two groups （ P 〉 0. 05 ）. Conclusion Compared with IMRT, VMAT combined with concurrent chemotherapy can reduce tumor size and reduce the blood toxicity in middle stage and advanced cervical cancer patients with good clinical application.

关 键 词：中晚期宫颈癌 容积旋转调强放疗 同步化疗 毒副反应 

分 类 号：R737.33[医药卫生—肿瘤]