CAJ | 학술논문

目的：探讨宫颈癌腹膜后淋巴结转移的调强适形放疗的临床疗效。方法整群选取于2012年1月-2013年3月该院妇科收治的78例宫颈癌腹膜后淋巴结转移患者为研究对象。根据患者及家属意愿选择放疗方式，其中40例接受常规放疗的患者为对照组，接受调强适形放疗的38例患者为研究组对象。对照组患者采用常规放疗法，研究组患者采用调强适形放疗法，两组患者均在放疗后接受紫杉醇+铂类的全身化疗，化疗时间为3~6个治疗周期。治疗结束后于0.6~3年内进行随访，比较两组患者的临床疗效以及放疗后不良反应的发生情况。结果治疗结束后于0.6~3年内进行随访，随访率为100%。对照组，总治疗有效率为35.0%。研究组总治疗有效率为79.0%。与对照组相比，研究组患者的治疗有效率显著较高，P<0.05。对照组总不良反应发生率为85.0%；研究组总不良反应发生率为28.9%。与对照组相比，研究组不良反应发生率明显降低，P<0.05。结论应用调强适形放疗能够进一步提高肿瘤内剂量，降低正常组织的剂量，提高疗效，降低并发症，值得临床推广应用。
목적：탐토궁경암복막후림파결전이적조강괄형방료적림상료효。방법정군선취우2012년1월-2013년3월해원부과수치적78례궁경암복막후림파결전이환자위연구대상。근거환자급가속의원선택방료방식，기중40례접수상규방료적환자위대조조，접수조강괄형방료적38례환자위연구조대상。대조조환자채용상규방요법，연구조환자채용조강괄형방요법，량조환자균재방료후접수자삼순+박류적전신화료，화료시간위3~6개치료주기。치료결속후우0.6~3년내진행수방，비교량조환자적림상료효이급방료후불량반응적발생정황。결과치료결속후우0.6~3년내진행수방，수방솔위100%。대조조，총치료유효솔위35.0%。연구조총치료유효솔위79.0%。여대조조상비，연구조환자적치료유효솔현저교고，P<0.05。대조조총불량반응발생솔위85.0%；연구조총불량반응발생솔위28.9%。여대조조상비，연구조불량반응발생솔명현강저，P<0.05。결론응용조강괄형방료능구진일보제고종류내제량，강저정상조직적제량，제고료효，강저병발증，치득림상추엄응용。
Objective To discuss the clinical effect of intensity modulated radiotherapy in the treatment of cervical cancer patients with retroperitoneal lymph node metastasis. Methods 78 cervical cancer patients with retroperitoneal lymph node metastasis admit-ted to the Department of Gynecologic Oncology of our hospital were selected as the research group and divided, according to radi-ation methods chosen by patients and their family members, into control group in which the 40 patients underwent conventional ra-diotherapy, and study group in which the 38 patients were given intensity modulated radiotherapy. After radiotherapy, all the pa-tients were given 3-6 treatment cycles of combined systemic chemotherapy of paclitaxel and platinum and 0.6-3 years follow-up. We compared the clinical effects and adverse reactions between the two groups. Results All the patients experienced a 0.6-3 years follow-up after treatment, which showed that the total effective rate was higher and the adverse reaction rate lower in the study group than in the control group with statistically significant differences, respectively 79.0% vs 35.0% and 28.9% vs 85.0%, P<0.05. Conclusion Intensity modulated radiotherapy, in the treatment of cervical cancer patients with retroperitoneal lymph node metastasis, has dosimetric advantage which can improve the treatment effect and reduce adverse reaction, therefore it is worthy of promotion in clinical practice.