^(192)Ir腔内加体外放射治疗宫颈癌118例分析  

^(192)Ir afterloading intracavitary brachytherapy and external beam radiotherapy for carcinoma of uterine cervix

作　　者：周陈华[1] 吕伟超[1] 陈华津[1] 王晓云[1] 叶鸿[1] 陈勇[1] 

机构地区：[1]浙江丽水市人民医院放射治疗科,323000

出　　处：《中华放射肿瘤学杂志》2002年第4期235-236,共2页Chinese Journal of Radiation Oncology

摘　　要：目的　研究1 92 Ir高剂量率腔内加体外放射治疗宫颈癌的疗效和放射反应。方法　 1 1 8例宫颈癌患者采用1 92 Ir高剂量率腔内加体外放射治疗 ,开始体外全盆腔照射 ,5次 /周 ,2Gy/次 ,盆腔平面中心剂量 2 6～ 40Gy ,2 .5～ 4 .0周完成 ;然后中间挡铅 ,4个野照射 ,4次 /周 ,2Gy/次 ,宫旁剂量 2 0～ 2 5Gy ;同时腔内治疗 ,1次 /周 ,6Gy/次 ,剂量为 36～ 42Gy。结果　全组 3、5年生存率分别为 83 .1 %和 72 .0 % ,Ⅱ、Ⅲ期 5年生存率分别为 80 .6 %和 58.7% (P >0 .0 5)。早期放射性直肠反应发生率为1 3 .6 % ,膀胱反应发生率为 5 .9% ;晚期放射性直肠炎发生率为 1 5 .3 % ,膀胱炎为 4 .2 % ,直肠阴道瘘为0 .9%。结论　1 92 Ir高剂量率腔内加体外照射治疗宫颈癌疗效肯定 ,应用方便 ,副作用少。Objective To study the therapeutic effect and complications of cervical carcinoma treated with 192 Ir afterloading intracavitary irradiation plus external beam radiation therapy (EBRT). Methods From June 1994 to March 1997,118 stage Ⅱ Ⅲ cervical cancer patients confirmed pathologically were treated with combination of HDR 192 Ir afterloading intracavitary brachytherapy plus EBRT. A midplane dose of 26 40?Gy to the whole pelvis and additional 20 25?Gy EBRT to the parametrical areas were given. Intracavitary brachytherapy was delivered to a total dose of 36 42?Gy at 6?Gy per fraction ,once a week. Results All patients were followed up over five years. The 3 and 5 year survival rates were 83.1% and 72.0%. The 5 year survival rates for stage Ⅱ and stage Ⅲ lesions were 80.6% and 58.7% (P>0.05). Immediate rectal reaction and late radioproctitis were present in 13.6% and 15.3%, acute and chronic radiation cystitis in 5.9% and 4.2%, respectively. Rectovaginal fistula developed in 0.9%. Conclusion HDR afterloading Intracavitary brachytherapy combined with external radiation is effective with equitable complications in the treatment of carcinoma of uterine cervix.

关 键 词：宫颈癌 放射疗法 近距离放射疗法 铱192 

分 类 号：R737.33[医药卫生—肿瘤]