三维适形放疗、调强放疗和容积调强放疗在宫颈癌术后患者中的应用  

The efficacies rates and side effects of different radiotherapy techniques for postoperative patients with early cervical cancer

作　　者：蒋军[1] 张利文[2] 廖珊[3] 陈默[1] 曾晓红[1] 何翰[1] 周菲菲[1] 闵燕飞[1] 邹育超[1] 黄荣[1] JIANG Jun;ZHANG Li-wen;LIAO Shan;CHEN Mo;ZENG Xiao-hong;HE Han;ZHOU Fei-fei;MIN Yan-fei;ZOU Yu-chao;HUANG Rong(Radiotherapy Department of Tumor Center,the First People's Hospital of Foshan,Foshan 528000,Guangdong,China;不详)

机构地区：[1]佛山市第一人民医院肿瘤中心放疗科,广东佛山528000 [2]佛山市第一人民医院物理室,广东佛山528000 [3]佛山市第一人民医院统计室,广东佛山528000

出　　处：《广东医学》2020年第23期2426-2429,共4页Guangdong Medical Journal

基　　金：佛山市医学类科技公关项目(2017AB001931)。

摘　　要：目的比较三维适形放疗(3D-CRT)、调强放疗(IMRT)和容积调强放疗(VMAT)技术在术后伴有中、高危因素的早期宫颈癌患者中的疗效及不良反应,探讨术后伴有中、高危因素的早期宫颈癌患者术后辅助放疗的最佳治疗模式。方法接受术后辅助放疗的120例具有中、高危因素的早期宫颈癌患者,按照随机数字表法平均分成3组,其中3D-CRT、IMRT及VMAT各40例,比较观察3种治疗方式的疗效及不良反应。结果3组1、2、3年生存率比较差异无统计学意义(P>0.05)。在不良反应方面,使用IMRT和VMAT技术患者的不良反应发生率相似(P>0.05);急性胃肠道反应和泌尿道反应发生率,IMRT和VMAT技术优于3D-CRT技术(P<0.05);放射性肠炎及膀胱炎的发生率,3D-CRT、IMRT和VMAT技术未发现差异(P>0.05)。结论具有中、高危因素的早期宫颈癌术后患者,采用IMRT、VMAT和3D-CRT技术放疗,其短期生存率相似,IMRT和VMAT不良反应的发生率低于3D-CRT;IMRT和VMAT不良反应发生率无明显差异。Objective To study the curative effects and adverse reactions of volumetric modulated arc therapy(VMAT),intensity-modulated radiotherapy(IMRT)and 3-dimensional conformal radiotherapy(3D-CRT)for early stage postoperative cervical cancer with medium-high risk factors,in order to investigate the best mode of postoperative adjuvant radiotherapy for early stage postoperative cervical cancer with medium-high risk factors.Methods To analyze the efficacies and adverse reactions of the 120 early stage cervical cancer patients with medium-high risk factors and postoperative radiotherapy in our hospital.They were evenly divided into 3D-CRT group,IMRT group and VMAT group,according to the random number table method.Results There was no statistically significant difference in 1-year,2-year,or 3-year survival rate among the 3 groups(P>0.05).The incidence of patients with IMRT and VMAT technolo-gy in terms of adverse reactions was similar(P>0.05).IMRT and VMAT in terms of acute gastrointestinal and urinary reactions were superior to 3D-CRT(P<0.05).In terms of the incidence of radiation proctitis and cystitis,no significant difference was found among 3D-CRT,IMRT and VMAT(P>0.05).Conclusion Our results suggest that the early stage postoperative cervical cancer with medium-high risk factors receiving adjuvant radiotherapy IMRT,VMAT or 3D-CRT have similar short-term survival rate;but IMRT and VMAT have lower toxicity compared with 3D-CRT.There is no significant difference in the incidence of adverse reactions between IMRT and VMAT.

关 键 词：宫颈癌 术后辅助放疗 三维适形放疗 容积调强放疗 调强放疗 

分 类 号：R737.33[医药卫生—肿瘤] R459.9[医药卫生—临床医学]