CAJ | 학술논문

目的比较强调的两种放疗方式并同步化疗治疗局部进展期宫颈癌,评价其治疗反应情况和疗效.方法符合入组条件的Ⅱa～Ⅲb期宫颈癌患者采用信封法随机分组,研究组制定IMRT放疗计划,对宫颈原发病灶予以45 Gy/22次,盆壁淋巴引流区50 Gy/22次；对照组靶区设定标准同研究组,采用四野盒式照射45 Gy/22次,其后予以盆壁补充6 Gy/3次.两组患者同期化疗方案相同,给予奈达铂30 mg/m2,每周1次,共6周期化疗.后装治疗于外照射3～4周开始,每次6 Gy,共6次,A点总剂量36Gy.结果自2006年9月至2009年9月,共招募72例患者,其中研究组36例,对照组36例.两组在恶心呕吐、血红蛋白下降、中性粒细胞下降等差异均无统计学意义；研究组Ⅲ级腹泻发生率为5.6％；对照组Ⅲ级腹泻发生率为30.6％,两组Ⅲ～Ⅳ级腹泻发生率比较差异有统计学意义(x2=31.35,P＜0.05).1、2、3年生存率分别为94.4％、86.1％、77.8％,1、2、3年无瘤生存率分别为91.7％、75.0％、72.2％,对照组1、2、3年生存率分别为91.7％、86.1％、75.0％,1、2、3年无瘤生存率分别为91.7％、72.2％、69.4％,差异无统计学意义.结论宫颈癌调强放疗并同步化疗可以明显减少急性直肠炎的发生率,总生存率与无病生存率与四野盒式照射相似.
목적 비교강조적량충방료방식병동보화료치료국부진전기궁경암,평개기치료반응정황화료효.방법 부합입조조건적Ⅱa～Ⅲb기궁경암환자채용신봉법수궤분조,연구조제정IMRT방료계화,대궁경원발병조여이45 Gy/22차,분벽림파인류구50 Gy/22차；대조조파구설정표준동연구조,채용사야합식조사45 Gy/22차,기후여이분벽보충6 Gy/3차.량조환자동기화료방안상동,급여내체박30 mg/m2,매주1차,공6주기화료.후장치료우외조사3～4주개시,매차6 Gy,공6차,A점총제량36Gy.결과 자2006년9월지2009년9월,공초모72례환자,기중연구조36례,대조조36례.량조재악심구토、혈홍단백하강、중성립세포하강등차이균무통계학의의；연구조Ⅲ급복사발생솔위5.6％；대조조Ⅲ급복사발생솔위30.6％,량조Ⅲ～Ⅳ급복사발생솔비교차이유통계학의의(x2=31.35,P＜0.05).1、2、3년생존솔분별위94.4％、86.1％、77.8％,1、2、3년무류생존솔분별위91.7％、75.0％、72.2％,대조조1、2、3년생존솔분별위91.7％、86.1％、75.0％,1、2、3년무류생존솔분별위91.7％、72.2％、69.4％,차이무통계학의의.결론 궁경암조강방료병동보화료가이명현감소급성직장염적발생솔,총생존솔여무병생존솔여사야합식조사상사.
Objective To study two different methods of radiotherapy and their side-effects in treating local advanced cervical cancer.Methods Eligible patients with stage Ⅱ a ～ Ⅲb cervical cancer were randomly divided into the study group and the control group.The patients in the study group were irradiated to 45 Gy/22 fractions at primary lesions and 50 Gy/22 fractions at lymphatic drainage using IMRT followed by high-dose rate (HDR) brachytherapy (36 Gy/6 fractions).The control group had the same target range sizes as the study group,and the patients were irradiated to 45 Gy/22 fractions at pelvic cavity and additional 6 Gy/3 fractions at pelvic wall using four-field cassette technique followed by highdose rate (HDR) brachytherapy (36/6 fractions).Both groups were treated with concurrent chemotherapy,by nedaplatin 30 mg/m2 weekly for a total of 6 cycles.Results Between Sep 2006 and Sep 2009,72 patients were enrolled into the study,and 36 cases were assigned in the study group and 36 cases in the control group.Nausea and vomiting,decline of hemoglobin and neutrophil were similar in two groups.Grade Ⅲ diarrhea in the study group and the control group was 5.6％ and 30.6％,respectively,with significant difference in diarrhea.1-,2-and 3-year overall survival rates of the study group were 94.4％,86.1％,77.8％,and 1-,2-and 3-year disease-free survival rate were 91.7％,75.0％,72.2％ in the study group.and 1-,2-and 3-year overall survival rate were 91.7％,86.1％,75.0％,and 1-,2-and 3-year disease-free survival rate were 91.7％,72.2％,69.4％ in the control group,respectively.There were no significant differences for overall survival and disease-free survival between two groups.Conclusions Intensity modulated radiation therapy with cervical cancer can reduce significantly the rate of acute proctitis.Overall survival and disease-free survival might be similar in two groups.