西南国防医药
西南國防醫藥
서남국방의약
MEDICAL JOURNAL OF NATIONAL DEFENDING FORCES IN SOUTHWEST CHINA
2015年
6期
621-623
,共3页
丁云霞%陈宏%王永刚%曹学武
丁雲霞%陳宏%王永剛%曹學武
정운하%진굉%왕영강%조학무
宫颈癌%调强放疗%腔内治疗%放射性直肠炎%放射性膀胱炎
宮頸癌%調彊放療%腔內治療%放射性直腸炎%放射性膀胱炎
궁경암%조강방료%강내치료%방사성직장염%방사성방광염
cervical cancer%intensity-modulated radiation therapy%intracavitary radiation therapy%radiation proctitis%radiation urocystitis
观察宫颈癌进行调强放疗(IMRT)加腔内放疗的疗效及副反应。185例(ⅡB~ⅣA)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，宫颈肿瘤组织照射总剂量为59.4~63.8 Gy(2.2 Gy/次)；盆腔淋巴引流区照射剂量：48.6~52.2 Gy(1.8 Gy/次)；盆腔或腹膜后淋巴结转移灶总量63.8~64.4 Gy(2.2~2.3 Gy/次)。盆腔IMRT后再行3~4次的腔内治疗(每次腔内放疗的A点剂量为5~6 Gy)，A点总量达78~82 Gy(IMRT+腔内放疗)。放疗后近期效果 CR率为98.92%；2、4及5年的生存率分别为87.03%、83.53%及81.25%，2、4、5年无病生存率为84.87%、81.18%及77.08%，2、4、5年的盆腔未控率为5.41%、7.06%及8.33%，2、4、5年的放射性直肠炎及膀胱炎发生率分别为4.32%、5.88%、6.25%；1.62%、2.35%、2.08%。IMRT+腔内放疗治疗宫颈癌具有很好的治疗效果，直肠及膀胱并发症发生率低。
觀察宮頸癌進行調彊放療(IMRT)加腔內放療的療效及副反應。185例(ⅡB~ⅣA)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，宮頸腫瘤組織照射總劑量為59.4~63.8 Gy(2.2 Gy/次)；盆腔淋巴引流區照射劑量：48.6~52.2 Gy(1.8 Gy/次)；盆腔或腹膜後淋巴結轉移竈總量63.8~64.4 Gy(2.2~2.3 Gy/次)。盆腔IMRT後再行3~4次的腔內治療(每次腔內放療的A點劑量為5~6 Gy)，A點總量達78~82 Gy(IMRT+腔內放療)。放療後近期效果 CR率為98.92%；2、4及5年的生存率分彆為87.03%、83.53%及81.25%，2、4、5年無病生存率為84.87%、81.18%及77.08%，2、4、5年的盆腔未控率為5.41%、7.06%及8.33%，2、4、5年的放射性直腸炎及膀胱炎髮生率分彆為4.32%、5.88%、6.25%；1.62%、2.35%、2.08%。IMRT+腔內放療治療宮頸癌具有很好的治療效果，直腸及膀胱併髮癥髮生率低。
관찰궁경암진행조강방료(IMRT)가강내방료적료효급부반응。185례(ⅡB~ⅣA)수치궁경암，채취전분강IMRT 27~29차，대분강내직장、방광、소장、고골두급분골진행필요적보호，궁경종류조직조사총제량위59.4~63.8 Gy(2.2 Gy/차)；분강림파인류구조사제량：48.6~52.2 Gy(1.8 Gy/차)；분강혹복막후림파결전이조총량63.8~64.4 Gy(2.2~2.3 Gy/차)。분강IMRT후재행3~4차적강내치료(매차강내방료적A점제량위5~6 Gy)，A점총량체78~82 Gy(IMRT+강내방료)。방료후근기효과 CR솔위98.92%；2、4급5년적생존솔분별위87.03%、83.53%급81.25%，2、4、5년무병생존솔위84.87%、81.18%급77.08%，2、4、5년적분강미공솔위5.41%、7.06%급8.33%，2、4、5년적방사성직장염급방광염발생솔분별위4.32%、5.88%、6.25%；1.62%、2.35%、2.08%。IMRT+강내방료치료궁경암구유흔호적치료효과，직장급방광병발증발생솔저。
To observe the curative effect and adverse reaction of intensity-modulated radiation therapy (IMRT) plus intracavitary radiation therapy (IRT) in treatment of cervical cancer. Total 185 patients (IIB-ⅣA) with cervical cancer to receive initial treatment were selected. Every patient received whole pelvic cavity IMRT for 27-29 times based on the necessary protection on the rectum, bladder, small intestine, whirlbone and pelvicum in the pelvic cavity. Gross irradiation dosage for the cervical carcinoma tissue was 59.4-63.8 Gy (2.25 Gy/time); gross irradiation dosage for the lymphatic drainage area in the pelvic cavity was 48.6-52.2 Gy (1.8 Gy/time);gross irradiation dosage for metastasis of retroperitoneal or pelvic lymph node was 63.8-64.4 Gy (2.2-2.3 Gy/time). Every patient further received IRT for 3-4 times (A-point dosage/time was 5-6 Gy) after pelvic cavity IMRT and gross A-point dosage reached 78-82 Gy (IMRT + IRT). The short term post-radiotherapy effect CR rate was 98.92%; the survival rates in the 2nd, 4th and 5th year were 87.03%, 83.53% and 81.25%, respectively. The disease-free survival rates in the 2nd, 4th and 5th year were 84.87%, 81.18%and 77.08%, respectively. The non-control rates of pelvic cavity in the 2nd, 4th and 5th year were 5.41%, 7.06% and 8.33%. The incidences of radiation proctitis in the 2nd, 4th and 5th year were 4.32%, 5.88% and 6.25%. The incidences of radiation urocystitis in the 2nd, 4th and 5th year were 1.62%, 2.35%, and 2.08%. IMRT+IRT can achieve a rather good curative effect in treatment of cervical cancer, while the incidence of complications of rectum and bladder is low.
