医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2015年
2期
24-25
,共2页
丁云霞%陈宏%曹学武%康保国
丁雲霞%陳宏%曹學武%康保國
정운하%진굉%조학무%강보국
宫颈癌%调强放疗(IMRT)%腔内治疗%放射性直肠炎%放射性膀胱炎
宮頸癌%調彊放療(IMRT)%腔內治療%放射性直腸炎%放射性膀胱炎
궁경암%조강방료(IMRT)%강내치료%방사성직장염%방사성방광염
Cervical cancer%IMRT%Intracavitary ir adiation%Radiation proctitis%Irradiation cystitis
目的：观察研究宫颈癌进行调强放疗(IMRT)加腔内治疗的疗效及副反应。方法185例(ⅡB郁A)首治宫颈癌,采取全盆腔IMRT 27~29次,对盆腔内直肠、膀胱、小肠、股骨头及盆骨进行必要的保护,宫颈肿瘤组织的总量院59.4~63.8Gy(2.2Gy/次)；主要淋巴引流区总量院48.6~53.2Gy(1.8Gy/次)。盆腔或腹膜后淋巴结转移灶总量63.8~64.4Gy(2.2~2.3Gy/次)。盆腔IMRT后再行3~4次的腔内治疗,A点总量达78~82Gy(调强放疗+腔内治疗)。结果放疗后近期效果达CR为98.92%。1年、2年及3年的生存率分别为院99.26%、88.24%及83.33%；无病生存率为院91.85%、84.71%及81.25%；盆腔未控率为4.44%、5.88%及8.33%。放射性直肠炎及膀胱炎发生率分别为3.78%~4.65%；0%~2.33%。结论 IMRT+腔内放疗治疗宫颈癌具有很好的治疗效果,盆腔控制率好,肠道及直肠膀胱放射的损伤及并发症低。
目的：觀察研究宮頸癌進行調彊放療(IMRT)加腔內治療的療效及副反應。方法185例(ⅡB鬱A)首治宮頸癌,採取全盆腔IMRT 27~29次,對盆腔內直腸、膀胱、小腸、股骨頭及盆骨進行必要的保護,宮頸腫瘤組織的總量院59.4~63.8Gy(2.2Gy/次)；主要淋巴引流區總量院48.6~53.2Gy(1.8Gy/次)。盆腔或腹膜後淋巴結轉移竈總量63.8~64.4Gy(2.2~2.3Gy/次)。盆腔IMRT後再行3~4次的腔內治療,A點總量達78~82Gy(調彊放療+腔內治療)。結果放療後近期效果達CR為98.92%。1年、2年及3年的生存率分彆為院99.26%、88.24%及83.33%；無病生存率為院91.85%、84.71%及81.25%；盆腔未控率為4.44%、5.88%及8.33%。放射性直腸炎及膀胱炎髮生率分彆為3.78%~4.65%；0%~2.33%。結論 IMRT+腔內放療治療宮頸癌具有很好的治療效果,盆腔控製率好,腸道及直腸膀胱放射的損傷及併髮癥低。
목적：관찰연구궁경암진행조강방료(IMRT)가강내치료적료효급부반응。방법185례(ⅡB욱A)수치궁경암,채취전분강IMRT 27~29차,대분강내직장、방광、소장、고골두급분골진행필요적보호,궁경종류조직적총량원59.4~63.8Gy(2.2Gy/차)；주요림파인류구총량원48.6~53.2Gy(1.8Gy/차)。분강혹복막후림파결전이조총량63.8~64.4Gy(2.2~2.3Gy/차)。분강IMRT후재행3~4차적강내치료,A점총량체78~82Gy(조강방료+강내치료)。결과방료후근기효과체CR위98.92%。1년、2년급3년적생존솔분별위원99.26%、88.24%급83.33%；무병생존솔위원91.85%、84.71%급81.25%；분강미공솔위4.44%、5.88%급8.33%。방사성직장염급방광염발생솔분별위3.78%~4.65%；0%~2.33%。결론 IMRT+강내방료치료궁경암구유흔호적치료효과,분강공제솔호,장도급직장방광방사적손상급병발증저。
Objective To evaluate disease outcomes and toxicity in cervical cancer patients treated with pelvic intensity-modulated radiation therapy (IMRT) and Ir-192 brachytherapy. Methods There were 185 patients with StageIIB-ⅣA cervical carcinoma treated with IMRT. Intensity-modulated radiation therapy plans were designed,which to deliver 59.4~63.8Gy to GTV in 2.2Gy daily fractions and 48.6~53.2Gy in 1.8Gy daily fractions to CTV, 63.8~64.4Gy in 2.2Gy or 2.3Gy daily fraction to the metastasis of the pelvic cavity and the retroperitoneal lymph node. while minimizing dose to the bowel, bladder, and rectum. After intensity-modulated radiation therapy is been complied, al patients underwent between three and four courses of high-dose rate intracavitary brachytherapy (HDRICB). Total prescribed point A doses (external beam radiotherapy + HDRICB ) ranged from 78Gy to 82 Gy. Results The rate of complete regression is 98.92% in cervical tumor. The overal survival rate and the disease-free survival rate of one-year, two-year and three-year, which were 99.26%, 88.24%and 83.33% ;91.85%, 84.71%and 81.25% respectively. The pelvic failure rate is 4.44%, 5.88%and 8.33%respectively, 1-year, 2-year and 3-year. There were very low radiation proctitis (3.78%~4.65%), and low ir adiation cystitis (0%~2.33%). Conclusion IMRT is favorable outcomes for cervical cancer, wihich may escalate dose with cervical tumor and lymph nodes metastasis, not increasing normal-tissue dose. It is may diminish ir adiation damage of the rectum and bladder.
