CAJ | 학술논문

目的观察一体化超分割后装治疗中晚期宫颈鳞癌的疗效及并发症的发生情况,并将其和常规后装治疗进行比较.方法观察组为2004年1月至2005年1月接受一体化超分割后装治疗的患者,共328例,每周治疗2次,每次A点剂量2.5～3.0 Gy,每周累积剂量5.0～6.0 Gy.A点平均总剂量Ⅱb期49.8 Gy,Ⅲb期52.6 Gy.对照组选择2002年1月至2003年12月接受常规后装治疗的患者,共331例,每次A点剂量5.0～7.0 Gy,每周治疗1次.A点平均总剂量Ⅱb期50.1 Gy,Ⅲb期53.5 Gy.体外照射开始时同时行腔内后装治疗,两组的体外照射方式相同,均采用直线加速器产生的15 MV X线行盆腔体外照射.结果观察组Ⅱb期近期控制率97.2%(104/107),Ⅲb期近期控制率94.1%(208/221).3年总生存率80.5%(264/328),5年总生存率为68.6%(225/328).放射性膀胱炎的发生率为5.2%(17/328),放射性直肠炎的发生率为14.6%(48/328).对照组Ⅱb期近期控制率95.4%(103/108),Ⅲb期近期控制率92.8%(207/223).3年总生存率75.2%(249/331),5年总生存率为62.5%(207/331).放射性膀胱炎的发生率为13.3%(44/331),放射性直肠炎的发生率为32.3%(107/331).结论一体化超分割后装加盆腔体外照射治疗中晚期宫颈鳞癌,在近期控制率和远期生存率方面与常规后装加盆腔体外照射相当,但是明显降低了并发症的发生率.
목적 관찰일체화초분할후장치료중만기궁경린암적료효급병발증적발생정황,병장기화상규후장치료진행비교.방법 관찰조위2004년1월지2005년1월접수일체화초분할후장치료적환자,공328례,매주치료2차,매차A점제량2.5～3.0 Gy,매주루적제량5.0～6.0 Gy.A점평균총제량Ⅱb기49.8 Gy,Ⅲb기52.6 Gy.대조조선택2002년1월지2003년12월접수상규후장치료적환자,공331례,매차A점제량5.0～7.0 Gy,매주치료1차.A점평균총제량Ⅱb기50.1 Gy,Ⅲb기53.5 Gy.체외조사개시시동시행강내후장치료,량조적체외조사방식상동,균채용직선가속기산생적15 MV X선행분강체외조사.결과 관찰조Ⅱb기근기공제솔97.2%(104/107),Ⅲb기근기공제솔94.1%(208/221).3년총생존솔80.5%(264/328),5년총생존솔위68.6%(225/328).방사성방광염적발생솔위5.2%(17/328),방사성직장염적발생솔위14.6%(48/328).대조조Ⅱb기근기공제솔95.4%(103/108),Ⅲb기근기공제솔92.8%(207/223).3년총생존솔75.2%(249/331),5년총생존솔위62.5%(207/331).방사성방광염적발생솔위13.3%(44/331),방사성직장염적발생솔위32.3%(107/331).결론 일체화초분할후장가분강체외조사치료중만기궁경린암,재근기공제솔화원기생존솔방면여상규후장가분강체외조사상당,단시명현강저료병발증적발생솔.
Objective To observe and cpmpare the efficacy and complications of hyperfractional integrated intraeavitary brachtherapy in middle-advanced squamous-cell carcinoma with the traditionsl brachytherapy.Methods In the observed group,328 patients with cervical cancer received hypeffractional integrated intracavitary after loading therapy between Jan 2004 and Jan 2005 were selected.The dose of point A was 2.5 Gy-3.0 Gy/fraction,2 fractions per week,and the total dose of reference point A was 49.8 Gy in stage Ⅱ b,52.6 Gy in stage in Ⅲb.In the control group,331 cases treated with traditional aflerloading brachytherapy between Jan 2002 and Dec 2003 were selected.The dose of point A was 5.0～7.0 Gy/fraction,1 fraction per week,and the total dose of point A was 50.1 Gy in stage Ⅱb,53.5 Gy in stage Ⅲb.In vitro irradiation began at the same time with the intracavitary brachytherapy.The whole pelvic was irradiated with 15 MV X-rays.Results In the observed group,the recent control rate of stage Ⅱb was 97.2%(104/107),94.1%(208/221)for stage Ⅲb.The 3-year survival rate was 80.5%(264/328).and the 5-year survival rate was 68.6%(225/328).The complication rate was 5.2%(17/328)for cystitis, 14.6%(48/328) for proctitis.Out of 331 cases in control group,the recent control rate of stage Ⅱb was 95.4%(103/108),92.8%(207/223)for stage Ⅲb.The 3-year survival rate was 75.2%(249/331),the 5-vear survival rate was 62.5%(207/331).The complication rate was 13.3%(44/331)for cystitis,and 32.3%(107/331)for proctitis.Conclusions Compared with combination of traditional brachytherapy and external radiotherapy,combination of hyperfraetional integrated brachtherapy therapy and external radiotherapy has no significant improvement for recent control rate and long-term survival rate,but could reduce the complication rates of cystitis and proctitis.