宫颈癌术后阴道断端复发调强放射联合插植近距离后装治疗效果分析  

The efficacy of intensity modulated radiotherapy combined with implanted brachytherapy in treatment of vaginal stump recurrence in patients with cervical cancer after surgery

作　　者：杨文翠[1] 赵林[1] 赵凤菊[1] 任锦霞[1] 田晓刚[1] 王小龙 YANG Wencui;ZHAO Lin;ZHAO Fengju(Department of Radiotherapy,Gansu Provincial Tumor Hospital,Gansu,Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院放疗科,兰州市730050 [2]西安国际医学中心医院肿瘤中心,710000

出　　处：《河北医药》2020年第24期3723-3727,共5页Hebei Medical Journal

摘　　要：目的分析宫颈癌术后阴道残端复发调强放射治疗联合插植近距离后装治疗的疗效及毒副反应。方法选择2013年1月至2014年12月收治的宫颈癌术后阴道断端复发患者65例,随机分为2组。ISBT组(37例)行调强放射治疗联合插植近距离后装治疗,ICBT组(28例)行调强放射治疗联合常规近距离后装治疗,2组放疗期间均给予顺铂周疗增敏治疗。比较2组的疗效差异和毒副反应。结果随访时间为12~45个月,随访率100%。ISBT组完全有效率CR+部分有效率PR 89.2%(33/37),ICBT组完全有效率CR+部分有效率PR 64.3%(18/28)。2组CR+PR比较差异有统计学意义(χ^2=5.306,P=0.021)。1、2、3年局控率,ISBT组分别为83.7%、72.9%、43.2%,ICBT组分别为75.7%、57.1%、10.7%,差异有统计学意义(χ^2=5.323,P=0.019)。1、2、3年生存率,ISBT组分别为86.5%、75.6%、43.2%,ICBT组分别为78.5%、60.7%、21.4%,差异有统计学意义(χ^2=4.758,P=0.029)。毒副反应:放射性膀胱炎发生率2组分别为10.8%、32.1%,2组比较差异有统计学意义(χ^2=4.533,P=0.033);放射性直肠炎发生率2组分别为13.5%、39.3%,差异有统计学意义(χ^2=5.795,P=0.012)。结论宫颈癌术后阴道断端复发调强放射治疗联合插植近距离后装治疗与体外三维适形放疗联合传统腔内放射治疗相比有明显优势,具有疗效好、毒副反应轻的特点,患者耐受性好。Objective To investigate the efficacy and toxic-adverse reactions of intensity modulated radiotherapy combined with implanted brachytherapy in treatment of vaginal stump recurrence in patients with cervical cancer after surgery.Methods A total of 65 cervical cancer patients with vaginal stump recurrence after surgery who were treated in our hospital from January 2013 to December 2014 were enrolled in the study,who were randomly divided into ISBT group(n=37)and ICBT group(28).The patients in ISBT group were treated by intensity modulated radiotherapy combined with implanted brachytherapy,however,thepatients in ICBT group were treated by intensity modulated radiotherapy combined with conventional brachytherapy,and the patients in both groups were treated by cisplatin weeks sensitization.The curative effects and the incidence rates of toxic-adverse reactions were observed and compared between the two groups.Results The follow up time was 12~45 months,with median follow up time being 27 months,and the follow up rate was 100%.The CR+PR was 89.2%(33/37)in ISBT group,and the CR+PR was 64.3%(18/28)in ICBT group,there was a significant difference in CR+PR between the two groups(P<0.05).The1-year,2-year,3-year local control rates in ISBT group were 83.7%,72.9%,43.2%,respectively,which in ICBT group were 75.7%,57.1%,10.7%,respectively,there were significant differences between the two groups(P<0.05).Moreover the 1-year,2-year,3-year survival rates in ISBT group were 86.5%,75.6%,43.2%,respectively,which in ICBT group were 78.5%,60.7%,21.4%,respectively,there were significant differences between the two groups(P<0.05).In addition there was a significant difference in incidence rate of radiation cystitis between ISBT group and ICBT group(10.8%vs 32.1%,P<0.05),and there was a significant difference in incidence rate of radiation proctitis between the two groups(13.5%vs 39.3%,P<0.05).Conclusion The intensity modulated radiotherapy combined with implanted brachytherapy is superior to intensity modulated radiotherapy combined with

关 键 词：宫颈癌 复发 放射治疗 调强放射治疗 近距离后装治疗 

分 类 号：R737.33[医药卫生—肿瘤]