不同加量方式调强放疗治疗盆腹腔淋巴结转移宫颈癌患者的疗效及安全性  

Efficacy and safety of intensity-modulated radiotherapy with different dose escalation methods in the treatment of cervical cancer patients with pelvic and abdominal lymph node metastasis

作　　者：李文裕 何静[2] 邱梅英 LI Wenyu;HE Jing;QIU Meiying(Department of Radiotherapy,Ganzhou Women and Children’s Health Care Hospital,Ganzhou 341000,Jiangxi,China;Department of Oncology,Ganzhou People’s Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣州市妇幼保健院放疗科,江西赣州341000 [2]赣州市人民医院肿瘤科,江西赣州341000

出　　处：《癌症进展》2024年第1期64-67,共4页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(20204568)。

摘　　要：目的探讨不同加量方式调强放疗治疗盆腹腔淋巴结转移宫颈癌患者的疗效及安全性。方法根据调强放疗加量方式的不同将82例盆腹腔淋巴结转移宫颈癌患者分为对照组(n=41,后程加量调强放疗)和研究组(n=41,同步加量调强放疗)。比较两组患者的临床疗效、危及器官照射剂量、治疗时间及不良反应发生情况。结果放疗完成时、放疗3个月后,研究组患者的客观缓解率(ORR)分别为92.68%、90.24%,分别高于对照组患者的73.17%、68.29%,差异均有统计学意义(P﹤0.05)。研究组患者直肠最大剂量(D_(max))、小肠D_(max)、膀胱D2cc均明显低于对照组(P﹤0.01)。研究组患者外照射时间和整体治疗完成时间均明显短于对照组(P﹤0.01)。研究组患者骨髓抑制发生率为34.15%,明显低于对照组患者的65.85%,差异有统计学意义(P﹤0.01)。结论与后程加量调强放疗相比,同步加量调强放疗治疗盆腹腔淋巴结转移的宫颈癌患者,可提高临床疗效,缩短治疗时间,减少危及器官照射剂量,降低骨髓抑制发生率。Objective To explore the efficacy and safety of intensity-modulated radiotherapy with different dose escalation methods in the treatment of cervical cancer patients with pelvic and abdominal lymph node metastasis.Method A total of 82 cervical cancer patients with pelvic and abdominal lymph node metastasis were divided into control group(n=41,received late course dose escalation intensity-modulated radiotherapy)and study group(n=41,received synchronous dose escalation intensity-modulated radiotherapy)according to different dose escalation methods.The clinical efficacy,radiation dose to organs at risk,treatment time,and occurrence of adverse events were compared between the two groups.Result At the completion of radiotherapy and three months after radiotherapy,the objective response rate(ORR)of the study group were 92.68%and 90.24%,which were higher than 73.17%and 68.29%of the control group,and the differences were statistically significant(P<0.05).The rectal Dmax,small intestinal D_(max),and bladder D2cc in the study group were significantly lower than those in the control group(P<0.01).The external irradiation time and overall treatment completion time in the study group were shorter than those in the control group(P<0.01).The incidence of bone marrow suppression in the study group was 34.15%,which was lower than 65.85%in the control group(P<0.01).Conclusion Compared with late course dose escalation intensity-modulated radiotherapy,synchronous dose escalation intensity-modulated radiotherapy can improve the clinical efficacy of cervical cancer patients with pelvic and abdominal lymph node metastasis,shorten treatment time,reduce radiation dose to organs at risk and the incidence of bone marrow suppression.

关 键 词：宫颈癌 后程加量 同步加量 调强放疗 盆腹腔淋巴结转移 照射剂量 

分 类 号：R737.33[医药卫生—肿瘤]