Ib2宫颈癌肿瘤中心前程同步瘤床加量放疗有效性及安全性分析  

Dosimetry and toxicity of early-course simultaneous integrated boost volumerotation intensity-modulated radiotherapy for Ib2 cervical cancer

作　　者：周云[1,4] 殷海涛 惠慧[1] 谢小妹 王超群[2] 吕茜 刘颖[3] ZHOU Yun;YIN Haitao;HUI Hui;XIE Xiaomei;WANG Chaoqun;LYU Qian;LIU Ying(Department of Radiation Oncology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China;Department of Pathology,Xuzhou Medical University,Xuzhou,Jiangsu 221004;Central Laboratory,Xuzhou Central Hospital;Xuzhou Institute of Medical Science,Xuzhou,Jiangsu 221006)

机构地区：[1]徐州市中心医院肿瘤放疗科,江苏徐州221009 [2]徐州医科大学病理学教研室,江苏徐州221004 [3]徐州市中心医院中心实验室 [4]徐州市医学科学研究所,江苏徐州221006

出　　处：《徐州医科大学学报》2020年第10期720-724,共5页Journal of Xuzhou Medical University

基　　金：徐州市科技计划项目(KC17111)。

摘　　要：目的探究Ib2宫颈癌肿瘤中心前程同步瘤床加量放疗的剂量学及毒性反应。方法选取徐州市中心医院2017年12月—2018年12月收治的31例行根治性容积旋转调强放疗的Ib2期宫颈癌患者作为研究对象,患者自主选择不同的放疗方法,入组研究组(采用肿瘤中心前程同步瘤床加量根治性容积旋转调强放疗,n=13)与对照组(采用根治性容积旋转调强放疗,n=18),观察2组患者的疗效及近期不良反应。结果研究组止血时间短于对照组,完全缓解(CR)率高于对照组,差异具有统计学意义(P<0.05)。放疗过程中研究组前程治疗肿瘤体积的退缩速度高于对照组;放疗结束后30 d,2组的肿瘤体积比较差异无统计学差异(P>0.05)。研究组小肠接受的平均剂量以及膀胱、直肠、骨盆、股骨头的受照射体积均高于对照组,但差异无统计学意义(P>0.05)。2组急性毒性反应发生率比较差异无统计学意义(P>0.05)。结论在Ib2期宫颈癌根治术后行前程同步瘤床加量根治性容积旋转调强放疗的止血效果显著,能够快速缩小肿瘤体积,且毒性反应发生率未见增高。Objective To explore the dosimetry and toxicity of early-course simultaneous integrated boost volume rotation intensity-modulated radiotherapy for Ib2 cervical cancer.Methods A total of 31 patients with stage Ib2 cervical cancer who were treated with volume rotation intensity-modulated radiotherapy in Xuzhou Central Hospital from December 2017 to December 2018 were selected as the research subjects.The patients chose different radiotherapy methods independently,and were assigned to a study group(treated with early-course simultaneous integrated boost volume rotation intensity-modulated radiotherapy,n=13)or a control group(treated with volume rotation intensity-modulated radiotherapy,n=18).The therapeutic effect and short-term adverse reactions of the two groups were observed.Results The hemostasis time in the study group was shorter than that in the control group and the complete response(CR)rate was higher than that in the control group(P<0.05).During the early-course radiotherapy,the tumor volume in the study group reduced faster than that in the control group;30 days after radiotherapy,there was no statistical difference in tumor volume between the two groups(P>0.05).Compared with the control group,the study group presented increases in the mean dose to the small intestine as well as the irradiated volume of the bladder,rectum,pelvis and femoral head,without statistical differences(P>0.05).There was no statistical difference in the incidence of acute toxic reactions between the two group(P>0.05).Conclusions The implementation of early-course simultaneous integrated boost volume rotation intensity-modulated radiotherapy after radical hysterectomy achieves remarkable hemostatic effect,and rapidly reduces the tumor volume.At the same time,the incidence of toxic reactions remains low.

关 键 词：Ib2宫颈癌 根治性容积旋转调强放疗 前程同步加量放疗 剂量学 毒性反应 

分 类 号：R815.6[医药卫生—放射医学]