盆腔高频聚焦热疗改善中晚期子宫颈癌同步放化疗患者急性放射性直肠炎的临床效果研究  

Efficacy of pelvic high-frequency focused hyperthermia in treatment of acute radiation proctitis in intermediate and advanced cervical cancer patients treated with concurrent chemoradiotherapy

作　　者：姚琴[1] 杨邵瑜[2] 吴侃[2] 张敏娜[2] 邓晚馨 张珂[1] 唐荣军[1] Yao Qin;Yang Shaoyu;Wu Kan;Zhang Minna;Deng Wanxin;Zhang Ke;Tang Rongjun(Hyperthermia Oncology Center,Hangzhou Cancer Hospital,Hangzhou 310002,China;Department of Thoracic Oncology,Hangzhou Cancer Hospital,Hangzhou 310002,China)

机构地区：[1]杭州市肿瘤医院热疗中心,浙江杭州310002 [2]杭州市肿瘤医院胸部肿瘤科,浙江杭州310002

出　　处：《实用肿瘤杂志》2025年第2期146-151,共6页Journal of Practical Oncology

基　　金：浙江省卫生健康科技计划(2022KY980);杭州市科技发展计划项目(2020ZDSJ0552)。

摘　　要：目的探讨盆腔高频聚焦热疗联合同步放化疗治疗中晚期子宫颈癌患者的急性放射性直肠炎的发生率和临床疗效。方法选取2020年6月至2021年6月杭州市肿瘤医院热疗中心收治的70例中晚期子宫颈癌患者。采用随机数字表法将患者分为盆腔容积旋转调强放疗(volumetric modulated arc therapy,VMAT)+阴道近距离放疗+含铂同步化疗组34例和盆腔高频聚焦热疗+盆腔VMAT+阴道近距离放疗+含铂同步化疗组36例。盆腔VMAT+阴道近距离放疗+含铂同步化疗组接受VMAT和腔内后装治疗同步顺铂化疗(40 mg/m^(2),每周1次,4~6次)治疗。盆腔高频聚焦热疗+盆腔VMAT+阴道近距离放疗+含铂同步化疗组在前者基础上同时联合盆腔高频聚焦热疗。比较两组临床疗效和急性放射性直肠炎的发生情况。结果与盆腔VMAT+阴道近距离放疗+含铂同步化疗组比较,盆腔高频聚焦热疗+盆腔VMAT+阴道近距离放疗+含铂同步化疗组近期有效率更高(86.1%vs 70.6%,P<0.05),2年无进展生存(progression free survival,PFS)率更高(82.7%vs 71.4%,P<0.05),有症状的急性放射性直肠炎的发生率更低(19.4%vs 44.1%,P<0.05)且严重程度较轻。结论同步放化疗联合盆腔高频聚焦热疗能有效降低中晚期子宫颈癌患者急性放射性直肠炎的发生率,减轻严重程度。其临床近期疗效好,可有效改善患者预后水平。Objective To explore the incidence of acute radiation proctitis(ARP)after concurrent radiotherapy and chemotherapy combined with pelvic high-frequency focused hyperthermia in patients with intermediate and advanced cervical cancer and the clinical efficacy of the treatment.Methods A total of 70 patients with intermediate and advanced cervical cancer admitted to Hyperthermia Oncology Center,Hangzhou Cancer Hospital,from June 2020 to June 2021,were selected.The random number table method was used to divide the patients into the pelvic volumetric modulated arc therapy(VMAT)+vaginal brachytherapy+platinum-containing concurrent chemotherapy group(n=34),which received VMAT,vaginal brachytherapy,and concurrent cisplatin chemotherapy(40 mg/m^(2),once a week,4-6 times),and the pelvic high-frequency focused hyperthermia+pelvic VMAT+vaginal brachytherapy+platinum-containing concurrent chemotherapy group(n=36),which received pelvic high-frequency focused hyperthermia combined with the treatment of the former group.The clinical efficacy and the occurrence of ARP were compared between the two groups.Results Compared with the pelvic VMAT+vaginal brachytherapy+platinum-containing concurrent chemotherapy group,the pelvic high-frequency focused hyperthermia+pelvic VMAT+vaginal brachytherapy+platinum-containing concurrent chemotherapy group had better short-term efficacy(86.1%vs 70.6%,P<0.05),higher 2-year progression free survival(PFS)rate(82.7%vs 71.4%,P<0.05),lower incidence of symptomatic ARP(19.4%vs 44.1%,P<0.05),and less severity of ARP.Conclusions Concurrent chemoradiotherapy combined with pelvic high-frequency focused hyperthermia can effectively reduce the incidence of ARP in patients with intermediate and advanced cervical cancer,and the ARP severity is mild.The treatment has good shortterm clinical efficacy,and can effectively improve patients'prognosis.

关 键 词：子宫颈癌 容积旋转调强放疗 高频聚焦热疗 化疗 急性放射性直肠炎 

分 类 号：R73[医药卫生—肿瘤]