三维插植后装放疗联合顺铂治疗宫颈癌患者的临床疗效  

Clinical Efficacy of Three Dimensional After Loading Radiotherapy Combined with Cisplatin in the Treatment of Cervical Cancer

作　　者：徐玉云[1] 叶玲[1] 陈爱辉[1] XU Yu-Yun;YE Ling;CHENAi-Hui(Department of Radiotherapy,Meizhou People's Hospital,Meizhou 514000,China)

机构地区：[1]梅州市人民医院放疗科,广东梅州514000

出　　处：《中国药物经济学》2020年第8期59-61,65,共4页China Journal of Pharmaceutical Economics

基　　金：梅州市科技计划项目(191205102052535)。

摘　　要：目的探讨三维插植后装放疗联合顺铂治疗宫颈癌患者的临床疗效。方法选取梅州市人民医院2018年5月至2020年5月收治的根治性放疗的初治宫颈癌患者64例作为研究对象,按照患者意愿治疗方式分为二维后装放疗组与三维后装放疗组,各32例。二维组行容积调强外照射放疗加二维后装放疗,三维组行容积调强外照射放疗加三维插植后装放疗,两组患者给予顺铂同期化疗。放疗结束后1~3月评价近期疗效,放化疗期间记录两组患者不良反应发生情况。结果放疗结束1~3个月,两组治疗有效率比较差异无统计学意义(P=0.302)。两组患者骨髓抑制发生率比较,差异无统计学意义(P=0.242)。二维组1~2级急性放射性肠炎发生率68.75%,三维组37.50%,两组无3级及以上放射性肠炎反应,差异有统计学意义(P=0.028)。仅二维组发生2例1级急性放射性膀胱炎事件,其他患者无明显急性放射性膀胱炎临床表现。结论顺铂同步放化疗治疗宫颈癌近期不良反应可耐受,三维插植后装放疗联合顺铂治疗宫颈癌与二维组比较降低了放射性肠炎发生率,提高了患者治疗的依从性及生命质量。Objective To explore the clinical efficacy of three-dimensional after loading radiotherapy combined with cisplatin in the treatment of cervical cancer.Methods A total of 64 patients with cervical cancer treated by radical radiotherapy in Meizhou People’s Hospital from May 2018 to May 2020 were selected as the research objects.According to the patients’wishes,they were divided into two-dimensional afterloading radiotherapy group and three-dimensional afterloading radiotherapy group,with thirty-two cases in each group.Patients in two-dimensional group were treated with volume modulated external radiotherapy plus two-dimensional afterloading radiotherapy,and three-dimensional patients in three-dimensional group were treated with volume modulated external radiotherapy and three-dimensional implantable brachytherapy.The short-term efficacy was evaluated one to three months after the end of radiotherapy,and the adverse reactions of the two groups were recorded during radiotherapy and chemotherapy.Results There was no significant difference in the effective rate between the two groups after 1-3 months of radiotherapy(P=0.302).There was no significant difference in the incidence of myelosuppression between the two groups(P=0.242).The incidence of grade 1-2 acute radiation enteritis was 68.75%in two-dimensional group and 37.50%in three-dimensional group.There was no grade 3 or above radiation enteritis reaction between the two groups(P=0.028).Only two cases of grade 1 acute radiation cystitis occurred in the two-dimensional group,and other patients had no obvious clinical manifestations of acute radiation cystitis.Conclusion The short-term adverse reactions of concurrent chemoradiotherapy with cisplatin in the treatment of cervical cancer are tolerable.Compared with the two-dimensional group,with the combination of three-dimensional after loading radiotherapy and cisplatin,the incidence of radiation enteritis is reduced,and the treatment compliance and quality of life of patients are improved.

关 键 词：CT引导 三维后装放疗 宫颈癌 近期疗效 放射性肠炎 

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