| 潘春霞,盛修贵,张小玲,等.一体化超分割后装治疗中晚期宫颈鳞癌的疗效和并发症观察[J].中华放射医学与防护杂志,2010,30(3):324-326.PAN Chun-xia,SHENG Xiu-gui,ZHANG Xiao-ling,et al.Observation of hyperfractional integrated intracavitary brachytherapy on efficacy and complications in patients with middle and advanced squamous cell carcinoma of the cervix[J].Chin J Radiol Med Prot,2010,30(3):324-326 |
| 一体化超分割后装治疗中晚期宫颈鳞癌的疗效和并发症观察 |
| Observation of hyperfractional integrated intracavitary brachytherapy on efficacy and complications in patients with middle and advanced squamous cell carcinoma of the cervix |
| 投稿时间：2009-09-04 |
| DOI：10.3760/cma.j.issn.0254-5098.2010.03.025 |
| 中文关键词: 宫颈肿瘤 后装治疗/一体化后装治疗 超分割 疗效 并发症 |
| 英文关键词:Cervix neoplasm Intracavitary brachytherapy/ Integrated intracavitary brachytherapy Hyperfactionation Efficacy Complications |
| 基金项目:山东省科技攻关项目(2009GG10002010) |
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| 中文摘要: |
| 目的 观察一体化超分割后装治疗中晚期宫颈鳞癌的疗效及并发症的发生情况,并将其和常规后装治疗进行比较。方法 观察组为2004年1月至2005年1月接受一体化超分割后装治疗的患者,共328例,每周治疗2次,每次A点剂量2.5~3.0 Gy,每周累积剂量5.0~6.0 Gy。A点平均总剂量Ⅱb期49.8Gy,Ⅲb期52.6Gy。对照组选择2002年1月至2003年12月接受常规后装治疗的患者,共331例,每次A点剂量5.0~7.0 Gy,每周治疗1次。A点平均总剂量Ⅱb期50.1 Gy,Ⅲb期53.5 Gy。体外照射开始时同时行腔内后装治疗,两组的体外照射方式相同,均采用直线加速器产生的15MV X线行盆腔体外照射。结果 观察组Ⅱb期近期控制率97.2%(104/107),Ⅲb期近期控制率94.1%(208/221)。3年总生存率80.5%(264/328),5年总生存率为68.6%(225/328)。放射性膀胱炎的发生率为5.2%(17/328),放射性直肠炎的发生率为14.6%(48/328)。对照组Ⅱb期近期控制率95.4%(103/108),Ⅲb期近期控制率92.8%(207/223)。3年总生存率75.2%(249/331),5年总生存率为62.5%(207/331)。放射性膀胱炎的发生率为13.3%(44/331),放射性直肠炎的发生率为32.3%(107/331)。结论 一体化超分割后装加盆腔体外照射治疗中晚期宫颈鳞癌,在近期控制率和远期生存率方面与常规后装加盆腔体外照射相当,但是明显降低了并发症的发生率。 |
| 英文摘要: |
| Objective To observe and cpmpare the efficacy and complications of hyperfractional integrated intracavitary brachtherapy in middle-advanced squamous-cell carcinoma with the traditional brachytherapy. Methods In the observed group,328 patients with cervical cancer received hyperfractional integrated intracavitary after loading therapy between Jan 2004 and Jan 2005 were selected. The dose of point A was 2.5 Gy-3.0 Gy/ fraction,2 fractions per week,and the total dose of reference point A was 49.8 Gy in stage Ⅱb, 52.6 Gy in stage Ⅲb.In the control group, 331 cases treated with traditional afterloading brachytherapy between Jan 2002 and Dec 2003 were selected. The dose of point A was 5.0~7.0 Gy /fraction,1 fraction per week, and the total dose of point A was 50.1 Gy in stage Ⅱb, 53.5 Gy in stage Ⅲb. In vitro irradiation began at the same time with the intracavitary brachytherapy. The whole pelvic was irradiated with 15 MV X-rays.Results In the observed group, the recent control rate of stage Ⅱb was 97.2%(104/107), 94.1%(208/221) for stage Ⅲb. The 3-year survival rate was 80.5% (264/328), and the 5-year survival rate was 68.6% (225/328).The complication rate was 5.2% (17/328) for cystitis, 14.6%(48/328) for proctitis. Out of 331 cases in control group, the recent control rate of stage Ⅱb was 95.4%(103/108),92.8%(207/223) for stage Ⅲb. The 3-year survival rate was 75.2%(249/331),the 5-year survival rate was 62.5%(207/331).The complication rate was 13.3%(44/331) for cystitis,and 32.3%(107/331) for proctitis.Conclusions Compared with combination of traditional brachytherapy and external radiotherapy, combination of hyperfractional integrated brachtherapy therapy and external radiotherapy has no significant improvement for recent control rate and long-term survival rate,but could reduce the complication rates of cystitis and proctitis. |
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