调强放疗同步剂量补偿高剂量率后装治疗局部晚期宫颈癌的临床价值  

Clinical value of IMRT synchronous dose compensation high dose rate reloading in the treatment of locally advanced cervical cancer

作　　者：董春红 张媛春 王馥旭 张瑞华[4] DONG Chun-hong;ZHANG Yuan-chun;WANG Fu-xu(Department of Oncology,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao Cancer Hospital,Qingdao Shandong 266000,China;Department of Neuroelectrophysiology,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao Cancer Hospital,Qingdao Shandong 266000,China;Operation Room,Qingdao Women's and Children's Hospital,Qingdao Shandong 266000,China)

机构地区：[1]青岛大学附属青岛市中心医院、青岛市肿瘤医院肿瘤科,山东青岛266000 [2]青岛大学附属青岛市中心医院、青岛市肿瘤医院神经电生理科,山东青岛266000 [3]青岛市妇女儿童医院手术室,山东青岛266000 [4]青岛大学附属青岛市中心医院、青岛市肿瘤医院全科医学科,山东青岛266000

出　　处：《临床和实验医学杂志》2023年第22期2420-2423,共4页Journal of Clinical and Experimental Medicine

基　　金：山东省医药卫生科技发展计划项目(编号:2018 WS48E)。

摘　　要：目的研究调强放疗(IMRT)同步剂量补偿高剂量率腔内后装(HDR-ICBT)治疗局部晚期宫颈癌的临床价值。方法以回顾性分析为法,观察对象为2017年1月至2020年1月入青岛大学附属青岛市中心医院治疗的100例局部晚期宫颈癌患者,所有患者均经病理诊断确诊为宫颈癌(肿瘤最大径≥5 cm或者6 cm,呈偏心性生长),且经盆腔外放疗与IMRT同步剂量补偿HDR-ICBT治疗。IMRT 45 Gy分25次,后装联合同步IMRT剂量补偿IR-CTV 5~6 Gy/次、HR-CTV 7 Gy/次,治疗频率为5次。同时100例宫颈癌患者均行顺铂75 mg/m^(2),基础同步化疗每21天治疗1次,观察随访2年局部控制率、无进展生存率、总生存率与不良反应发生率。结果100例宫颈癌患者均予以随访,随访时间2年。放射治疗过程中及完成后评估疗效,总有效率为100.00%,其中76例患者完全缓解(76.00%),24例患者部分缓解(24.00%)。随访2年局部控制率为95.00%,无进展生存率为86.00%,总生存率为90.00%。泌尿系统、消化道1~2级早期不良反应发生率分别为15.00%(15/100)、59.00%(59/100),3级早期不良反应发生率分别为3.00%(3/100)、7.00%(7/100);泌尿系统、消化道1~2级晚期不良反应发生率分别为6.00%(6/100)、1.00%(1/100),3级晚期不良反应发生率均为1.00%(1/100)。结论IMRT同步剂量补偿HDR-ICBT治疗局部晚期宫颈癌临床疗效显著,局部控制率、总生存率均较高,且严重不良反应少。Objective To study the clinical value of intensity modulated radiation therapy(IMRT)synchronous dose compensation high dose rate intracavitary brachytherapy(HDR-ICBT)in the treatment of locally advanced cervical cancer.Methods By retrospective analysis,100 patients with locally advanced cervical cancer admitted to Qingdao Central Hospital Affiliated to Qingdao University from January 2017 to January 2020 were observed.All patients were confirmed as cervical cancer by pathological diagnosis(maximum diameter of tumor≥5 cm or 6 cm,presenting eccentric growth).Besides,external pelvic radiotherapy and IMRT were synchronously dose-compensated with HDR-ICBT.IMRT 45 Gy was divided into 25 times,post-loading combined with synchronous IMRT dose compensation IR-CTV 5-6 Gy/time,HR-CTV 7 Gy/time,the treatment frequency was 5 times.Meanwhile,100 patients with cervical cancer received cisplatin 75 mg/m^(2),and basic synchronous chemotherapy was treated once every 21 days.The local control rate,progression-free survival rate,overall survival rate and the incidence of adverse reactions were observed at 2 years follow-up.Results One hundred patients with cervical cancer were followed up for 2 years.The total effective rate was 100.00%,including 76 patients with complete remission(76.00%)and 24 patients with partial remission(24.00%).The local control rate,progression-free survival rate and overall survival rate were 95.00%,86.00%and 90.00%at 2-year follow-up.The incidence of early adverse reactions of urinary system and digestive tract were 15.00%(15/100)and 59.00%(59/100)at grade 1-2,and 3.00%(3/100)and 7.00%(7/100)at grade 3,respectively.The incidence of late adverse reactions in urinary system and digestive tract of grade 1-2 was 6.00%(6/100)and 1.00%(1/100),respectively,and the incidence of late adverse reactions of grade 3 was 1.00%(1/100).Conclusion IMRT synchronous dose compensation HDR-ICBT is effective in the treatment of local advanced cervical cancer,with higher local control rate and overall survival rate,and fewer s

关 键 词：高剂量率后装疗法 宫颈癌 调强放疗 同步剂量补偿 局部晚期 

分 类 号：R737.33[医药卫生—肿瘤]