子宫切除术后高级别阴道上皮内瘤变高剂量率腔内近距离治疗的临床效果  

Clinical effect of high dose rate intracavitary brachytherapy in patients with high grade vaginal intraepithelial neoplasia after hysterectomy

作　　者：李凤霜[1] 吴玉梅[1] 王建东[1] 孔为民[1] 宋芳[1] 张玉溪 岳志云 孙阳 LI Fengshuang;WU Yumei;WANG Jiandong;KONG Weimin;SONG Fang;ZHANG Yuxi;YUE Zhiyun;SUN Yang(Department of Gynecological Oncology,Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院妇瘤科,北京1000060

出　　处：《癌症进展》2018年第8期984-986,1023,共4页Oncology Progress

摘　　要：目的探讨子宫切除术后高级别阴道上皮内瘤变(HG-VAIN)行高剂量率腔内近距离治疗(HDRICR)的临床效果和不良反应。方法回顾性分析13例HG-VAIN患者的病历资料,其中VAINⅡ1例,VAINⅢ12例,所有患者均仅接受HDR-ICR,选择阴道圆柱体和(或)阴道卵圆体施源器治疗。所有患者均进行随访,观察患者的复发与生存情况及近、远期并发症发生情况。结果 13例HG-VAIN患者的随访时间为12~117个月,中位随访时间为55个月;1例患者于治疗后22个月复发,经手术治疗后得到有效控制,治疗总有效率为92.3%(12/13)。13例HG-VAIN患者中,3例患者出现近期不良反应,其中1~2级直肠反应1例,1级泌尿系统不良反应2例,且近期不良反应均较轻;6例患者出现远期不良反应,其中2级直肠反应3例,3级泌尿系统不良反应2例,3~4级阴道狭窄和溃疡1例。结论 HDR-ICR对子宫切除术后HG-VAIN患者是一种非常有效的治疗方法,治愈率高,且近期和远期不良反应可耐受。Objective To investigate the clinical effect and adverse effect of high dose rate intracavitary brachythera- py （HDR-ICR） in patients with high grade vaginal intraepithelial neoplasia （HG-VAIN） after hysterectomy. Method A retrospective analysis was performed among 13 patients with HG-VAIN. Out of the 13 patients, one case had VAIN II and twelve cases had VAIN III. All patients underwent HDR-ICR as the only treatment, with a vaginal cylinder and/or oval ap- plicator. All patients followed-up and the recurrence, survival status and short and long-term complications were ob- served. Result The median overall follow-up time for 13 patients was 55 months （range 12-117 months）. One case re- curred in 22 months after therapy, and were under control after surgery. The totle effective rate of treatment was 92.3% （12/13）. Among 13 patients, three patients had short-term complications, including grade 1-2 rectal reaction in 1 case, grade 1 urinary reaction in 2 cases, which were all mild. Six cases had long-term complications, including grade 2 rectal reaction in 3 cases, grade 3 urinary reaction in 2 cases, grade 3-4 vaginal stricture and ulcer in 1 case. Conclusion HDR- ICR is an effective treatment regimen for patients with HG-VAIN after hysterectomy, with a high cure rate and acceptable short- and long-term complications.

关 键 词：阴道肿瘤 原位癌 放射治疗 近距离治疗 

分 类 号：R711.74[医药卫生—妇产科学]