中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2014年
4期
279-282
,共4页
赵建国%杨昊%郁志龙%索志敏
趙建國%楊昊%鬱誌龍%索誌敏
조건국%양호%욱지룡%색지민
宫颈癌%调强放疗%顺铂
宮頸癌%調彊放療%順鉑
궁경암%조강방료%순박
Cervical cancer%Intensity-modulated radiotherapy(IMRT)%Cisplatin
目的 观察宫颈癌患者调强放疗(IMRT)联合顺铂治疗疗效及不良反应.方法 回顾性分析100例宫颈癌患者,按治疗方法不同分为单纯治疗组和联合治疗组,每组各50例,均给予IMRT外照射,总剂量为50 Gy,2 Gy/次,共25次,5次/周;外照射2周时开始行内照射,1次/周,6～7 Gy/次,共6～8次,总剂量为42～48 Gy.联合治疗组加顺铂同步化疗,静脉滴注,1次/周,30～40 mg/m2,连用4～5周.观察近期疗效和1、3、5年生存率,局部控制率、远处转移率和无瘤生存率,并评价两组患者的不良反应.结果 联合治疗组与单纯治疗组比较,近期疗效及1年生存率,局部控制率、远处转移率、无瘤生存率无明显差异,联合治疗组的3年与5年生存率、局部控制率、远处转移率、无瘤生存率均优于单纯治疗组(x2=3.843、4.336、4.336、4.960,P＜0.05;x2=3.934、4.454、4.000、4.244,P＜0.05).联合治疗组放射性直肠炎、白细胞总反应率高于单纯治疗组(x2=4.110、4.320,P＜0.05),两组膀胱炎、贫血、血小板总反应率比较无差异,均未出现3～4级直肠炎和膀胱炎.结论 IMRT联合顺铂同步化疗治疗宫颈癌比单纯IMRT疗效好.
目的 觀察宮頸癌患者調彊放療(IMRT)聯閤順鉑治療療效及不良反應.方法 迴顧性分析100例宮頸癌患者,按治療方法不同分為單純治療組和聯閤治療組,每組各50例,均給予IMRT外照射,總劑量為50 Gy,2 Gy/次,共25次,5次/週;外照射2週時開始行內照射,1次/週,6～7 Gy/次,共6～8次,總劑量為42～48 Gy.聯閤治療組加順鉑同步化療,靜脈滴註,1次/週,30～40 mg/m2,連用4～5週.觀察近期療效和1、3、5年生存率,跼部控製率、遠處轉移率和無瘤生存率,併評價兩組患者的不良反應.結果 聯閤治療組與單純治療組比較,近期療效及1年生存率,跼部控製率、遠處轉移率、無瘤生存率無明顯差異,聯閤治療組的3年與5年生存率、跼部控製率、遠處轉移率、無瘤生存率均優于單純治療組(x2=3.843、4.336、4.336、4.960,P＜0.05;x2=3.934、4.454、4.000、4.244,P＜0.05).聯閤治療組放射性直腸炎、白細胞總反應率高于單純治療組(x2=4.110、4.320,P＜0.05),兩組膀胱炎、貧血、血小闆總反應率比較無差異,均未齣現3～4級直腸炎和膀胱炎.結論 IMRT聯閤順鉑同步化療治療宮頸癌比單純IMRT療效好.
목적 관찰궁경암환자조강방료(IMRT)연합순박치료료효급불량반응.방법 회고성분석100례궁경암환자,안치료방법불동분위단순치료조화연합치료조,매조각50례,균급여IMRT외조사,총제량위50 Gy,2 Gy/차,공25차,5차/주;외조사2주시개시행내조사,1차/주,6～7 Gy/차,공6～8차,총제량위42～48 Gy.연합치료조가순박동보화료,정맥적주,1차/주,30～40 mg/m2,련용4～5주.관찰근기료효화1、3、5년생존솔,국부공제솔、원처전이솔화무류생존솔,병평개량조환자적불량반응.결과 연합치료조여단순치료조비교,근기료효급1년생존솔,국부공제솔、원처전이솔、무류생존솔무명현차이,연합치료조적3년여5년생존솔、국부공제솔、원처전이솔、무류생존솔균우우단순치료조(x2=3.843、4.336、4.336、4.960,P＜0.05;x2=3.934、4.454、4.000、4.244,P＜0.05).연합치료조방사성직장염、백세포총반응솔고우단순치료조(x2=4.110、4.320,P＜0.05),량조방광염、빈혈、혈소판총반응솔비교무차이,균미출현3～4급직장염화방광염.결론 IMRT연합순박동보화료치료궁경암비단순IMRT료효호.
Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix.Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only (IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group),with 50 cases in each.Both groups were treated with external intensity modulated radiotherapy,with the total dose of 50 Gy,2 Gy/fraetion,25 fractions in total,and 5 times/week.Two weeks later,internal radiotherapy followed,with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction.When the internal radiotherapy began,the external radiotherapy stopped immediately.The combination group was treated concurrently with cisplatin given by intravenous drip once a week,at the dose of 30-40 mg/m2 body surface area for 4-5 weeks,and with total cisplatin dosage of 50-65 mg.Follow-up was conducted for 18 months(3-60 months).The 1-,3-,and 5-year survival rates,local control rate,distant metastasis rate,and disease-free survival rate,blood test,rectum,and bladder were observed.Results The 1-year survival rate,local control rate,distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups,however,the 3-and 5-year survival rates,local control rates,distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (x2 =3.843,4.336,4.336,4.960,P ＜ 0.05 ; x2 =3.934,4.454,4.000,4.244,P ＜0.05).The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (x2 =4.110,4.320,P ＜ 0.05),whereas the incidence rates of cystitis,anemia,and thrombocytopenia were not significantly different between these 2 groups.No serious grade 3-4 proctitis and cystitis were observed in these 2 groups.Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group.
