CAJ | 학술논문

目的：观察252锎腔内后装治疗联合盆腔三维适形放疗治疗宫颈癌的直肠、膀胱并发症，对治疗方案进行安全性评价。方法：收集2011年1月-2012年12月宫颈癌病例共89例，采用252锎中子腔内后装治疗和盆腔三维适形放疗同时进行的方法进行治疗。其中，252锎中子腔内后装治疗，宫旁A点剂量为6～7Gy／次，1次／周，共进行6～7次，使宫旁A点累积剂量达35～42Gy ；盆腔外照射采用三维适形放疗，总剂量46～50Gy ；A点全程总剂量达70Gy以上，治疗计划中直肠累积最大受量＜60Gy。结果：急性放射性膀胱损伤率为9．0％（8／89），急性放射性直肠损伤率为15.7％（14／89），1例患者出现RTOG 3级晚期放射性直肠反应及RTOG 2级晚期放射性膀胱反应。结论：252锎中子腔内放射治疗联合盆腔三维适形放疗治疗宫颈癌，在严格限制直肠累积受照剂量的条件下，合理提高A点照射剂量，并发症少。
목적：관찰252개강내후장치료연합분강삼유괄형방료치료궁경암적직장、방광병발증，대치료방안진행안전성평개。방법：수집2011년1월-2012년12월궁경암병례공89례，채용252개중자강내후장치료화분강삼유괄형방료동시진행적방법진행치료。기중，252개중자강내후장치료，궁방A점제량위6～7Gy／차，1차／주，공진행6～7차，사궁방A점루적제량체35～42Gy ；분강외조사채용삼유괄형방료，총제량46～50Gy ；A점전정총제량체70Gy이상，치료계화중직장루적최대수량＜60Gy。결과：급성방사성방광손상솔위9．0％（8／89），급성방사성직장손상솔위15.7％（14／89），1례환자출현RTOG 3급만기방사성직장반응급RTOG 2급만기방사성방광반응。결론：252개중자강내방사치료연합분강삼유괄형방료치료궁경암，재엄격한제직장루적수조제량적조건하，합리제고A점조사제량，병발증소。
Objective :The aim of the study was to investigate the radiation complications of rectum and bladder during 252-Californium brachytherapy with three-dimensional conformal radiotherapy for cervical cancer .Methods :89 patients with cervical cancer treated by radical radiation therapy between January 2011 and December 2012 were included in this study .252-Californium neutron brachytherapy and external radiation were performed sequentially .252-Califorium neu-tron brachytherapy was performed with one fraction of 6~7Gy dose at reference A point every week and the total dose at A point was 30~ 42Gy .The whole pelvis was treated with three-dimensional conformal radiotherapy with total dose 46~50Gy .The total radiation dose at A point from both external beam and 252-Californium was over 70Gy .The maxi-mum dose of the rectum was less than 60Gy .Results:The acute radiation complications of bladder and rectum were 9%and 15 .7% respectively .The late radiation complications in rectum of grades 3 (according to the RTOG/EORTC standard) only observed in one case .Conclusion:252-Combination the Californium brachytherapy with external three-di-mensional conformal radiotherapy can be well tolerated by cervical cancer patients when the maximum dose of the rec-tum w as less than 60Gy .