中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
2期
96-99
,共4页
同步放化疗%伽马刀治疗%宫颈癌
同步放化療%伽馬刀治療%宮頸癌
동보방화료%가마도치료%궁경암
concurrent chemo-radiotherapy%gamma knife therapy%cervical cancer
目的：评价同步放化疗联合伽马刀治疗伴盆腔淋巴结转移宫颈癌的疗效及不良反应。方法：回顾性分析42例内蒙古医科大学附属医院说明放疗科同步放化疗治疗伴淋巴结转移宫颈癌患者。外照射三维适形调强放疗（IMRT）的盆腔剂量PTV为50.4 Gy/28 F，淋巴结剂量为PGTVnd 59.92 Gy/28 F，联合腔内照射剂量为36 Gy/6 F。同步化疗方案为顺铂40 mg/m2/周，静脉滴注。同步放化疗结束后3个月复查，对淋巴结仍有残存患者行局部伽马刀治疗，剂量为10～15 Gy/3～4 F。结果：3个月近期疗效为83.3%（35/42）。6、9、12个月局部控制率分别为88.1%（37/42）、83.3%（35/42）、80.0%（32/40）。1、2年生存率分别为77.5%（31/40）、70.0%（28/40）。主要不良反应包括放射性小肠炎[11.9%（5/42）]、直肠炎[38.1%（16/42）]、膀胱炎[7.1%（3/42）]、消化道反应[90.5%（38/42）]与粒细胞减少[85.7%（36/42）]，其中绝大多数为1～2级反应。结论：同步放化疗联合伽马刀治疗伴盆腔淋巴结转移宫颈癌疗效较好，不良反应在可接受范围之内，是临床可行的治疗手段。
目的：評價同步放化療聯閤伽馬刀治療伴盆腔淋巴結轉移宮頸癌的療效及不良反應。方法：迴顧性分析42例內矇古醫科大學附屬醫院說明放療科同步放化療治療伴淋巴結轉移宮頸癌患者。外照射三維適形調彊放療（IMRT）的盆腔劑量PTV為50.4 Gy/28 F，淋巴結劑量為PGTVnd 59.92 Gy/28 F，聯閤腔內照射劑量為36 Gy/6 F。同步化療方案為順鉑40 mg/m2/週，靜脈滴註。同步放化療結束後3箇月複查，對淋巴結仍有殘存患者行跼部伽馬刀治療，劑量為10～15 Gy/3～4 F。結果：3箇月近期療效為83.3%（35/42）。6、9、12箇月跼部控製率分彆為88.1%（37/42）、83.3%（35/42）、80.0%（32/40）。1、2年生存率分彆為77.5%（31/40）、70.0%（28/40）。主要不良反應包括放射性小腸炎[11.9%（5/42）]、直腸炎[38.1%（16/42）]、膀胱炎[7.1%（3/42）]、消化道反應[90.5%（38/42）]與粒細胞減少[85.7%（36/42）]，其中絕大多數為1～2級反應。結論：同步放化療聯閤伽馬刀治療伴盆腔淋巴結轉移宮頸癌療效較好，不良反應在可接受範圍之內，是臨床可行的治療手段。
목적：평개동보방화료연합가마도치료반분강림파결전이궁경암적료효급불량반응。방법：회고성분석42례내몽고의과대학부속의원설명방료과동보방화료치료반림파결전이궁경암환자。외조사삼유괄형조강방료（IMRT）적분강제량PTV위50.4 Gy/28 F，림파결제량위PGTVnd 59.92 Gy/28 F，연합강내조사제량위36 Gy/6 F。동보화료방안위순박40 mg/m2/주，정맥적주。동보방화료결속후3개월복사，대림파결잉유잔존환자행국부가마도치료，제량위10～15 Gy/3～4 F。결과：3개월근기료효위83.3%（35/42）。6、9、12개월국부공제솔분별위88.1%（37/42）、83.3%（35/42）、80.0%（32/40）。1、2년생존솔분별위77.5%（31/40）、70.0%（28/40）。주요불량반응포괄방사성소장염[11.9%（5/42）]、직장염[38.1%（16/42）]、방광염[7.1%（3/42）]、소화도반응[90.5%（38/42）]여립세포감소[85.7%（36/42）]，기중절대다수위1～2급반응。결론：동보방화료연합가마도치료반분강림파결전이궁경암료효교호，불량반응재가접수범위지내，시림상가행적치료수단。
Objective:To evaluate therapeutic efficacy and adverse reactions of synchronous chemoradiotherapy combined with gamma knife therapy for pelvic lymph node metastasis of cervical cancers. Methods:Data of 42 cervical cancer patients who suffered from residual pelvic lymph node metastasis and received concurrent chemoradiotherapy were retrospectively analyzed. Intensity-modu-lated radiotherapy was used in the treatment. The prescribed doses of planning target volume and pelvic metastasized lymph node of the planned gross tumor volume were 50.4 Gy/28 F and 59.92 Gy/28 F, respectively. The combined internal irradiation dose was 6 Gy/6 F. Concurrent chemotherapy was administered with 40 mg/m2·w cisplatin. Three months after chemoradiotherapy was completed, the pa-tients with residual pelvic positive lymph node received additional dose ranging from 10 Gy to 15 Gy at three or four fractions by using a gamma knife. Results:Near-term efficacy was 83.3%(35/42) in three months. Local control rates were 88.1%(37/42), 83.3%(35/42), and 76.2%(32/42) in 6, 9, and 12 months, respectively. The 1-and 2-year survival rates were 77.5%(31/40) and 70.0%(28/40), re-spectively. The incidence rates of radiation enteritis, proctitis, cystitis, gut toxicity, and neutrocytopenia were 11.9%(5/42), 38.1%(16/42), 7.1%(3/42), 90.5%(38/42), and 85.7%(36/42), respectively, and the majority of these conditions were classified as grades I and II. Conclusion:Synchronous chemoradiotherapy combined with gamma knife therapy is an effective and feasible treatment method for pelvic lymph node metastasis of cervical cancer;this method exhibits a minimal adverse reaction.
