三维调强放疗结合CT引导三维插植腔内后装治疗中晚期宫颈癌患者的有效性及安全性  

Efficacy and safety of three-dimensional intensity modulated radiation therapy combined with CT-guided three-dimensional implantation within the post-implant treatment in the treatment of patients with advanced cervical cancer

作　　者：关明丽 GUAN Mingli(Oncology Radiotherapy Department,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院肿瘤放疗科,河南洛阳471000

出　　处：《临床医学研究与实践》2024年第21期79-82,共4页Clinical Research and Practice

摘　　要：目的探讨三维调强放疗(IMRT)结合CT引导下三维插植腔内后装治疗在中晚期宫颈癌患者中的应用效果。方法选取2020年9月至2022年9月我院收治的98例中晚期宫颈癌患者作为研究对象,根据治疗方法不同将其分为对照组(49例,行IMRT)和研究组(49例,行IMRT结合CT引导下三维插植腔内后装治疗)。比较两组的治疗效果。结果研究组的治疗总有效率为79.59%,高于对照组的51.02%(P<0.05)。治疗后,研究组的血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)、基质金属蛋白酶-9(MMP-9)、胸苷激酶1(TK1)及人附睾蛋白4(HE4)水平低于对照组(P<0.05)。治疗后,两组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)下降,CD8^(+)升高(P<0.05);治疗后,研究组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。研究组的骨髓抑制、胃肠道反应、白细胞减少、放射性直肠炎及放射性膀胱炎发生率低于对照组(P<0.05)。结论三维IMRT结合CT引导下三维插植腔内后装治疗方案应用于中晚期宫颈癌患者可进一步提升肿瘤病灶治疗效果,降低血清因子表达水平,对免疫功能影响较小,且治疗安全性高。Objective To investigate the application effect of three-dimensional intensity modulated radiation therapy(IMRT)combined with CT-guided three-dimensional implantation within the post-implant treatment in patients with advanced cervical cancer.Methods A total of 98 patients with advanced cervical cancer admitted in our hospital from September 2020 to September 2022 were selected as the research objects.According to different treatment methods,the patients were divided into control group(49 patients,undergoing IMRT)and study group(49 patients,undergoing IMRT combined with CT-guided three-dimensional implantation within the post-implant treatment).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the study group was 79.59%,which was higher than 51.02%in the control group(P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2),matrix metalloproteinase-9(MMP-9),thymidine kinase 1(TK1)and human epididymis protein 4(HE4)in the study group were lower than those in the control group(P<0.05).After treatment,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups decreased,and the CD8^(+)increased(P<0.05);after treatment,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were higher than those in the control group,and the CD8^(+)was lower than that in the control group(P<0.05).The incidences of bone marrow suppression,gastrointestinal reactions,leukopenia,radiation proctitis and radiation cystitis in the study group were lower than those in the control group(P<0.05).Conclusion The three-dimensional IMRT combined with CT-guided three-dimensional implantation within the post-implant treatment applied in patients with advanced cervical cancer can further improve the therapeutic effect of tumor lesions,reduce the expression levels of serum factors,and has little effect on immune function and high treatment safety.

关 键 词：宫颈癌 调强放疗 三维插植腔内后装治疗 

分 类 号：R737.33[医药卫生—肿瘤]