摘要
目的：比较252 Cf中子腔内照射结合挡铅盆腔对穿野和不挡铅箱式四野外照射治疗宫颈癌的治疗结果。方法2004—2007年本院收治的Ⅱa—Ⅲb 期的宫颈鳞癌患者，按照临床分期、年龄、肿瘤大小、贫血程度为配对条件，共筛选出26对（52例）研究对象，分为挡铅盆腔对穿野组（挡铅组）和不挡铅箱式四野组（不挡铅组）。两组患者外照射期间穿插252 Cf中子后装治疗。 Kaplan.Meier法计算5年LC、OS、DFS 并 Logrank 检验差异，晚期并发症发生率差异行 McNemar 法检验。结果挡铅、不挡铅组5年LC 率分别为85％、81％（P＝0.014），OS 率分别为89％、73％（P＝0.013），DFS 率分别为89％、73％（P＝0.013），晚期并发症发生率分别为12％、23％（P＝0.008）。结论腔内照射结合外照射治疗宫颈癌时无论采取对穿野还是箱式四野，后程前后野中央均应挡铅。
Objective To compare the efficacy between californium.252 （ 252 Cf ） neutron intraluminal brachytherapy combined with external.beam radiotherapy with lead.shielding pelvic parallel opposing field technique and non.lead.shielding four.field box technique for cervical cancer. Methods A total of 52 patients with stage Ⅱa.Ⅲb cervical squamous cell carcinoma who were admitted to our hospital from 2004 to 2007 were enrolled as subjects and paired by clinical stage, age, tumor size, and degree of anemia. The 26 pairs of patients were divided into lead.shielding pelvic parallel opposing field group （lead.shielding group） and non.lead.shielding four.field box group （non.lead.shielding group）. For all patients in both groups, 252 Cf neutron brachytherapy was added in external.beam radiotherapy. The local control （LC）, overall survival （OS）, and disease.free survival （DFS） rates were calculated using the Kaplan.Meier method and analyzed using the log.rank test. The difference in the incidence of late complications was analyzed using the McNemar method. Results There were significant differences in 5.year LC, OS, and DFS rates between the lead.shielding group and the non.lead.shielding group （85% vs. 81%, P= 0. 014;89% vs. 73%, P=0. 013; 89% vs. 73%, P= 0. 013 ）. There was also significant difference in the incidence of late complications between the lead.shielding group and the non.lead.shielding group （ 12% vs. 23%, P=0. 008）. Conclusions When intraluminal brachytherapy combined with external.beam radiotherapy is used to treat cervical cancer, the centers of the front and back fields should be shielded by lead, regardless of whether the parallel opposing field technique or the four.field box technique is used.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2015年第4期400-403,共4页
Chinese Journal of Radiation Oncology
关键词
宫颈肿瘤/
放射疗法
放射疗法
外照射
放射疗法
252-锎中子
挡铅
Cervical neoplasms/ radiotherapy
Radiotherapy,external beam radiation
Radiotherapy,252 Cf neutron
Lead shielding
