摘要
目的应用宫腔管和柱状体施源器高剂量率后装治疗中下段阴道受侵犯宫颈癌患者的疗效。方法高剂量率后装治疗采用核通公司后装机192Ⅰγ治疗,以A点和阴道黏膜下0.5 cm处为参考点,处方剂量为600~700 cGy,每周1次或2次,共5~7次。直肠≤60%A点处方剂量,膀胱≤70%A点处方剂量。结果中位随访时间16个月,随访率100.00%。患者均完成治疗计划。完全有效率CR和部分有效率PR分别为92.11%(35/38)和100.00%(38/38)。有13例治疗过程出现Ⅱ~Ⅲ度阴道黏膜放射反应,对症治疗后好转。2例治疗结束后出现放射性直肠炎,无1例出现溃疡。结论宫腔管和柱状体施源器高剂量后装治疗,配合外照射对阴道中下段受侵犯的宫颈癌患者的疗效较好,剂量分布可覆盖阴道中下段受犯病灶,不良反应少,患者均能耐受。
Objective To evaluate the outcome and benefit of tandem and cylinder(TC) for high-dose-rate brachytherapy(HDR) in the treatment of cervix carcinomas with the lower half of the vaginal infiltration.Methods 32 were squamous carcinoma,4 were adenocarcinoma,2 were adenosquamous carcinoma.According to the FIGO system,4 cases were stage Ⅱa,7cases Ⅱb,5 cases Ⅲa,12 cases Ⅲb.34 cases combinded with chemotherapy.All of the patients began with conventional fractionated radiotherapy by 6-18MV X-ray to a total dose of DT30~40 Gy in 3 to 4 weeks,followed by center shielding to DT 10~22 Gy.which made point B to DT 50~52 Gy.Some cases were used parametral boost to DT56 Gy if parametral was involved.Patients with pelvic lymph nodes metestases were get boost to DT60~62 Gy.HDR was performed weekly and concurrently with the centrally shieded EBRT.5~7 sessions of TC-HDR were applied in the processe of the brachytherapy.Results All patients complete the treatment with a mean followed-up of 16 months.CR is 92.11%(35/38)and PR is 100.00%(38/38),13 patients developed gradeⅡto III vaginal mucosa reaction.All the patients could tolerate the treatment.Conclusion HDR brachytherapy by tandem and cylinder applicator combined with external radiotherapy is effective for patients with cervix cancer with the lower half of the vaginal infiltration.The dose could cover the whole vagina disease with slight toxicities.
出处
《实用癌症杂志》
2011年第3期290-293,共4页
The Practical Journal of Cancer
关键词
宫颈癌
放射治疗
后装治疗
A点
施源器
Cervical cancer
Radiotherapy
Brachytherapy
A point
Applicator