摘要
目的比较调强放疗(IMRT)与三维适形放疗(3D-CRT)联合腔内后装放疗治疗中晚期宫颈癌的近期疗效及安全性。方法根据治疗方案的不同,将85例初治中晚期宫颈癌患者分为IMRT组43例和3D-CRT组42例。IMRT组进行IMRT治疗,3D-CRT组进行3D-CRT治疗,且2组均给予腔内后装放疗联合同步化疗,比较2组近期疗效、急慢性放射性损伤的发生情况及复发、转移与生存情况。结果 IMRT组总有效率(97.7%)有高于3D-CRT组(92.9%)的趋势,但差异无统计学意义(P>0.05)。IMRT组血小板下降和消化道损伤发生率及随访期间的肠道慢性放射性损伤发生率均显著低于3D-CRT组,差异有统计学意义(P<0.05或P<0.01)。2组远处转移率、局部复发率、死亡率、无疾病进展生存率及总生存率比较,差异均无统计学意义(P>0.05)。结论 IMRT联合腔内后装放疗能明显减轻中晚期宫颈癌患者的血液学及胃肠道损伤,且疗效与3D-CRT相似。
Objective To compare the short-term efficacy and safety of intensity modulated radiotherapy （IMRT） and three-dimensional conformal radiotherapy （3D-CRT） combined with after-loading intra-cavity radiation in the treatment of patients with middle and advanced cervical cancer. Methods According to different therapeutic protocols, 85 patients with middle and advanced cervical cancer were divided into IMRT group （43 cases） and 3D-CRT group （42 cases）. After- loading intra-cavity radiation combined with concurrent chemotherapy was given to both groups, on which basis IMRT group was added with IMRT and 3D-CRT group with 3D-CRT. Short-term efficacy, acute and chronic radioactive damage and conditions of recurrence, metastasis and survival were compared between two groups, Results The total dfective rate of IMRT group was 97.7 %, higher than the 92.9% in 3D-CRT group, but there was no significant difference （ P 〉0.05）. IM- RT group was prominently lower than 3D-CRT group in the rates of platelet decrease and digestive duct injury as well as the rate of chronic radioactive damage during follow-up period, and there was significant difference （ P 〈 0 . 0 5 or P 〈 0 . 0 1 ） . However , there was no significant difference between two groups in distant metastatic rate , local recurrent rate , mortality , progression - free survival and overall survival rate （P 〉 0.05）. Conclusion IMRT combined with after-loading intra-cavity radiation can effectually alleviate the hematological and gastrointestinal damages of patients with middle and advance cervical cancer, which is similar to 3D-CRT in clinical efficacy.
出处
《实用临床医药杂志》
CAS
2015年第17期67-70,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11523058)
关键词
中晚期宫颈癌
三维适形放疗
调强放疗
腔内后装放疗
毒副反应
middle and advanced cervical cancer
three-dimensional conformal radiotherapy
intensity modulated radiotherapy
after-loading intra-cavity radiation
toxic response
