途中调整放疗靶区范围对局部晚期宫颈癌患者疗效和不良反应的影响  

Effect of modulating radio-therapeutic target range on efficacy and adverse reactions in local advanced cervical cancer

作　　者：蓝柳 陈海辉[2] 刘威 赵迎喜 莫玉珍 LAN Liu;CHEN Haihui;LIU Wei;ZHAO Yingxi;MO Yuzhen(Third Ward,Department of Radiotherapy,the Second Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou 545005,Guangxi,China;Department of Oncology,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545005,Guangxi,China;Department of Oncology,Guangzhou Red Cross Hospital,Guangzhou 510220,Guangdong,China)

机构地区：[1]广西科技大学第二附属医院肿瘤放射治疗三病区,广西柳州545005 [2]广西医科大学第四附属医院肿瘤科,广西柳州545005 [3]广州红十字会医院肿瘤科,广州510220

出　　处：《癌症进展》2022年第15期1542-1545,1549,共5页Oncology Progress

基　　金：广西高校中青年教师科研基础能力提升项目(2020KY08030);柳州市应用技术研究与开发计划项目(2010030728)。

摘　　要：目的研究局部晚期宫颈癌放疗途中调整放疗靶区范围对疗效及不良反应的影响。方法将273例接受调强放疗的局部晚期宫颈癌患者按是否途中调整放疗靶区范围分为调整靶区组(129例)和非调整靶区组(144例),观察两组患者生存情况、放射区域内复发情况、放射性直肠炎及放射性膀胱炎发生情况。结果调整靶区组和非调整靶区组患者的3年、5年总生存率比较,差异均无统计学意义(P﹥0.05)。调整靶区为≥1级和≥3级放射性直肠炎的独立影响因素(OR=0.495、0.106,95%CI:0.256~0.960、0.014~0.853,P﹤0.05)。结论对于局部晚期宫颈癌患者,调强放疗途中调整放疗靶区范围是有效和安全的,不影响患者生存时间和疗效,并且明显降低了放射性直肠炎的发生风险。Objective To study the effect of modulating radio-therapeutic target range on efficacy and adverse reactions in local advanced cervical cancer.Method A total of 273 patients with local advanced cervical cancer who received intensity modulated radiation therapy(IMRT) were divided into the modulation group(n=129) and non-modulation group(n=144) according to whether radio-therapeutic target range was modulated halfway.Survival,recurrence within radio-therapeutic range,radiation proctitis,and radiation cystitis were analyzed.Result The 3-year and 5-year overall survival rates of the modulation group and non-modulation group were no statistical significance between the two groups(P>0.05).Modulation of target range was independent influence factors for ≥1 and ≥3 grade radiation proctitis(OR=0.495,0.106;95%CI:0.256-0.960,0.014-0.853;P<0.05).Conclusion The modulation of radio-therapeutic target range during IMRT in patients with local advanced cervical cancer is effective and safe,which has no effect on survival and efficacy and can significantly reduce risk of radiation proctitis.

关 键 词：宫颈癌 调强放疗 放疗靶区 放射性直肠炎 放射性膀胱炎 

分 类 号：R737.33[医药卫生—肿瘤]