摘要
目的通过低氧放疗子宫颈癌,探讨保护骨髓及腹盆部淋巴等正常组织与远期生存的关系。方法113例子宫颈癌均经病理证实。将其按期别不同分层随机分为低氧放疗组(低氧组57例)和常规放疗组(对照组56例)。低氧组在放疗前1～2min内开始吸入含氧体积分数为0.105的低氧气体,持续至该野照射完毕,每野连续照射≤5min,换野时重复上述过程。对照组为常规放疗。依期别不同给全盆中平面剂量DT20～50Gy,宫旁四分野中平面剂量DT15～34Gy。腔内治疗A点剂量为15～34Gy。结果疗后外周血WBC下降平均值低氧组为(1.36±1.27)×109/L,对照组为(2.97±1.19)×109/L(P<0.05)。低氧组E花环上升(6.00±2.39)%,淋巴细胞转化率上升(3.78±1.83)%;对照组分别下降(3.97±1.88)%和(4.47±1.73)%(P<0.01)。5年生存率低氧组为65%,对照组为57%(P<0.05)。放射性直肠炎和放射性膀胱炎发生率差异也有统计学意义(P<0.01、0.05)。结论对子宫颈癌采取低氧放疗可明显保护骨髓造血及细胞免疫功能,并能提高远期生存率和改善生存质量。
Objective To evaluate the relationship between long-term survival rate and protection to marrow and lymphoid tissues in the pelvis with hypoxia radiotherapy for uterine cervical carcinoma. Methods 113 patients, confirmed as having carcinoma of uterine cervix by pathology, were randomly divided by the envelope method into two groups： hypoxia radiotherapy group （HRG, 57 patients） and conventional radiotherapy group （CRG,56 patients）. HRG was given by sustained inhaling hypoxia gas （oxygen physical volume = 0. 105） for two minutes before the start of radiotherapy till the end of radiotherapy of each field and then repeated for the other field in the same way. The duration of irradiation to each field was less than five minutes. CRG was given with conventional radiotherapy. The irradiation dose in the midpelvieal plane was 20-50 Gy depending on the different stages of cervical carcinomatous lesion. The dose of four-divided-field in the parametria was 15-34 Gy.The dose at point A of intracavitary therapy was 15-35 Gy. Results The decreased value of peripheral blood white cells after treatment was （ 1.36 ± 1.27） × 10^9/L in HRG and （2.97 ± 1.19） × 10^9/L in CRG（ P 〈 0.05）. E flower ring test （EFRT） increased by （6.00 ± 2.39） % and lymphocyte transformation rate（LTR） increased by （3.78 ±1.83） % in HRG, but decreased by （3.97± 1.88）%and （4.47± 1.73）%in CGR（P 〈 0.01）.The 5-year survival rate was 65% in HRG and 57% in CRG（ P 〈 0.05） .The incidence of complications such as radiation proctitis and radiocystitis was also of statistically significant （ P 〈 0.01,0.05）. Conclustions Hematopoisis and columnar immunity can be protected by hypoxia radiotherapy for uterine cervical cancer. As a result, both long-term survival rate and life quality of patients are expected to be improved.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第3期204-207,共4页
Chinese Journal of Radiation Oncology
关键词
宫颈肿瘤/放射疗法
低氧
预后
Cervical neoplasms/radiotherapy
Hypoxia
Prognosis
