三维腔内后装放疗联合化疗对晚期宫颈癌患者的临床疗效及对周围组织的照射剂量  

Efficacy of three dimensional intracavitary afterloading radiotherapy combined with chemotherapy for advanced cervical cancer and the radiation dose to surrounding tissues

作　　者：王佩[1] 岳成山 王会霞[1] 刘亚军[1] 丁海燕[1] 余昌 张愉[1] 童雅兰 王艳容 WANG Pei;YUE Cheng-shan;WANG Hui-xia;LIU Ya-jun;DING Hai-yan;YU Chang;ZHANG Yu;TONG Ya-lan;WANG Yan-rong(Department of Radiotherapy,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]陕西省汉中市中心医院放疗科,汉中723000

出　　处：《中国肿瘤临床与康复》2020年第11期1351-1354,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨三维腔内后装放疗联合化疗对晚期宫颈癌的治疗效果及对周围组织的照射剂量。方法选取2017年1月至2019年1月间汉中市中心医院收治的106例晚期宫颈癌患者,采用随机数表法分为观察组和对照组,每组53例。两组患者均采用顺铂单药化疗和调强外放疗治疗,观察组患者采用三维腔内后装放疗,对照组患者采用常规二维腔内后装放疗,比较两组患者的治疗效果、靶区适形指数、靶区覆盖指数及危及器官体积指数,膀胱2cm3受照剂量(D2cc)、乙状结肠D2cc和直肠D2cc的照射剂量及不良反应发生情况。结果观察组患者客观缓解率为71.7%,高于对照组的50.9%,差异有统计学意义(P<0.05)。观察组患者靶区适形指数和靶区覆盖指数均高于对照组,危及器官体积指数低于对照组,差异均有统计学意义(均P<0.05)。观察组患者膀胱D2cc、乙状结肠D2cc和直肠D2cc的照射剂量均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者放射性肠炎和放射性膀胱炎发生率均低于对照组,差异均有统计学意义(均P<0.05);两组患者骨髓抑制和胃肠道反应发生率比较,差异无统计学意义(P>0.05)。结论三维腔内后装放疗联合化疗可提高晚期宫颈癌的治疗效果,对周围组织的照射剂量小,不良反应发生率低,值得临床借鉴。Objective To investigate the therapeutic effectiveness of three dimensional intracavitary afterloading radiotherapy combined with chemotherapy for advanced cervical cancer and the radiation dose to surrounding tissues.Methods A total of 106 patients with advanced cervical cancer admitted to Hanzhong Central Hospital from January 2017 to January 2019 were selected and randomly divided into an observation group and a control group with 53 patients in each group.Both groups were administrated with chemotherapy with cisplatin plus intensity modulated radiotherapy.The observation group was given three dimensional intracavitary afterloading radiotherapy and the control group was given conventional two-dimension intracavicular afterloading radiotherapy.The treatment effectiveness,target area conformation index,target area coverage index and organ damaged volume index,bladder/sigmoid colon/rectum D 2 cm3(D2cc)and adverse reactions were compared the two groups.Results The objective remission rate was 71.7%in the observation group which was significantly higher than 50.9%of the control group(P<0.05).The target area conformation index and target area coverage index were significantly higher in the observation group than in the control group(all P<0.05),and the organ at risk volume index was significantly lower in the observation group than in the control group(P<0.05).Bladder/sigmoid colon/rectum D2cc were lower in the observa-tion group than in the control group(all P<0.05).The incidence of radiation enteritis and cystitis was significantly lower in the observation group than in the control group(P<0.05),and there was no statistically significant difference in the incidence of bone marrow suppression and gastrointestinal reactions between the two groups(P>0.05).Conclusion Three-dimensional intracavitary radiotherapy combined with chemotherapy can improve the treatment effectiveness for advanced cervical cancer with small effect on surrounding tissues and the incidence of adverse reactions is low,which is worthy of clinical

关 键 词：三维腔内后装放疗 药物疗法 宫颈肿瘤 照射剂量 

分 类 号：R737.3[医药卫生—肿瘤]