摘要
目的:探讨CT引导下三维腔内后装放疗联合体外调强放疗(IMRT)、顺铂治疗晚期宫颈癌的效果。方法:选取97例晚期宫颈癌患者进行回顾性研究,其中55例患者采用CT引导下三维腔内后装放疗联合IMRT、顺铂治疗(观察组),42例患者采用二维腔内后装放疗联合IMRT、顺铂治疗(对照组)。观察并比较两组患者治疗前后效果、危及器官放射损伤程度、患者3年预后结局差异。结果:经过联合放化疗,观察组治疗有效率显著高于对照组(98.18%vs 88.10%, P<0.05)。放疗过程中,观察组小肠、膀胱、直肠接受放疗的平均受照射剂量、2.0 cm^(3)受照射剂量均显著低于对照组(P<0.05),观察组骨髓抑制、放射性直肠炎、放射性膀胱炎的发生程度均显著低于对照组(P<0.05);随访3年,两组生存率无统计学差异(P>0.05),观察组患者3年的中位生存时间长于对照组(P<0.05)。结论:CT引导下三维腔内后装放疗联合IMRT、顺铂治疗晚期宫颈癌的效果优于二维腔内后装放疗联合IMRT、顺铂治疗,对危及器官的放射性损伤程度更低,患者的生存时间更长。
Objective To investigate the clinical outcome in advanced cervical cancer patients treated with CT-guided threedimensional intracavitary brachytherapy combined with intensity-modulated radiotherapy(IMRT) and cisplatin chemotherapy. Methods Among 97 advanced cervical cancer patients selected for retrospective analysis, 55 patients received CT-guided three-dimensional intracavity brachytherapy combined with IMRT and cisplatin chemotherapy(observation group), and the other 42 patients were treated with two-dimensional intracavitary brachytherapy combined with IMRT and cisplatin chemotherapy(control group). The treatment outcome, radiation damage to organs-at-risk, and 3-year prognostic outcomes were compared between two groups. Results After radiochemotherapy, the proportion of CR+PR patients in observation group was 98.18%, higher than 88.10% in control group(P<0.05). The average radiation dose and 2.0 cm^(3) radiation dose to the small intestine, bladder and rectum were significantly lower in observation group than in control group(P<0.05), and the incidences of myelosuppression, radiation proctitis and radiation cystitis in observation group were significantly lower than those in control group(P<0.05). After 3 years of follow-up, the survival rate in observation group was close to that of control group(P>0.05), but the 3-year median survival time in observation group was longer than that in control group(P<0.05). Conclusion CT-guided three-dimensional intracavity brachytherapy combined with IMRT and cisplatin chemotherapy is more effective than two-dimensional intracavity brachytherapy combined with IMRT and cisplatin chemotherapy, with less radiation damage to organs-at-risk and longer survival time.
作者
杨杰
郭丽宁
许汴菊
YANG Jie;GUO Lining;XU Bianju(Department of Obstetrics and Gynecology,the First Hospital of Yulin,Yulin 719000,China)
出处
《中国医学物理学杂志》
CSCD
2022年第10期1213-1216,共4页
Chinese Journal of Medical Physics
关键词
宫颈癌
CT引导
三维腔内后装放疗
调强放射治疗
顺铂
cervical cancer
CT-guided
three-dimensional intracavitary brachytherapy
intensity-modulated radiotherapy
cisplatin
