摘要
目的探讨计算机断层扫描(CT)引导下三维后装放疗治疗宫颈癌的疗效。方法36例行根治性放疗的宫颈癌患者在体外调强放疗结束后行CT图像引导下铱-192(^192Ir)三维腔内后装放疗,观察患者治疗结束后1个月、1年的局部控制率及不良反应。结果36例患者共完成144次腔内后装放疗,高危临床靶区(HRCTV)D90、膀胱D2cc、直肠D2cc、乙状结肠D2cc、小肠D2cc剂量分别为(692±32)、(445±53)、(414±48)、(421±52)、(386±62)cGy。36例患者治疗结束后1个月完全缓解(CR)率为78%(28/36),治疗结束后1年CR率为86%(31/36)。治疗结束后1个月及1年主要不良反应均为放射性膀胱炎、放射性肠炎、骨髓抑制,大多数为轻度不良反应,无Ⅳ级不良反应出现。结论CT引导下^192Ir三维腔内后装放疗联合体外调强外照射治疗宫颈癌,患者放疗靶区个体化,计划剂量分布可见可控,可有效提高靶区剂量,减少危及器官受量,从而提高治疗效果,值得临床推广。
Objective To investigate the efficacy of three-dimensional intracavitary brachytherapy for cervical cancer guided by computed tomography(CT).Method A total of 36 patients with cervical cancer who received radical radiotherapy ^192Ir three-dimensional intracavitary brachytherapy guided by CT image after the end of intensity modulated radiation therapy(IMRT).The local control rate and adverse reactions were observed at 1 month and 1 year after treatment.Result A total of 144 intracavitary brachytherapy was performed in 36 patients.The dose of high risk-clinical target volume(HRCTV)D90,bladder D2cc,rectum D2cc,sigmoid D2cc and small intestine D2cc were(692±32),(445±53),(414±48),(421±52),(386±62)cGy respectively.The complete response(CR)rate for one month was 78%(28/36)and 86%(31/36)for one year after the completion of ^192Ir three-dimensional radiotherapy.One month and one year after treatment,the main adverse reactions were radiation cystitis,radiation enteritis and myelosuppression,most of which were mild adverse reactions,and no grade IV adverse reactions occurred.Conclusion CT image-guided ^192Ir three-dimensional intracavitary brachytherapy combined with the radical IMRT each patient’s radiotherapy target area is individualized,and the planned dose distribution is visible and controllable.It can effectively improve the target area dose and reduce the dose of organs at risk,thus improving the treatment effect which is worthy of clinical promotion.
作者
郭爱华
冯梅
钟沛霖
王玲华
林秀容
GUO Aihua;FENG Mei;ZHONG Peilin;WANG Linghua;LIN Xiurong(Department of Radiation Gynaecology,Fujian Cancer Hospital&Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian,China)
出处
《癌症进展》
2020年第22期2316-2318,2376,共4页
Oncology Progress
关键词
宫颈癌
影像引导
三维后装放疗
放疗反应
治疗效果
cervical cancer
image-guided
three-dimensional intracavitary brachytherapy
radiotherapy response
treatment effect
