| 赵建国,杨昊,郁志龙,等.调强放疗联合顺铂治疗宫颈癌的临床观察[J].中华放射医学与防护杂志,2014,34(4):279-282.Zhao Jianguo,Yang Hao,Yu Zhilong,et al.Clinical effects of intensity modulated radiotherapy combined with cisplatin for patients with carcinoma of cervix[J].Chin J Radiol Med Prot,2014,34(4):279-282 |
| 调强放疗联合顺铂治疗宫颈癌的临床观察 |
| Clinical effects of intensity modulated radiotherapy combined with cisplatin for patients with carcinoma of cervix |
| 投稿时间：2013-07-15 |
| DOI：10.3760/cma.j.issn.0254-5098.2014.04.010 |
| 中文关键词: 宫颈癌 调强放疗 顺铂 |
| 英文关键词:Cervical cancer Intensity-modulated radiotherapy(IMRT) Cisplatin |
| 基金项目:内蒙古自然科学基金（2013MS1186） |
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| 中文摘要: |
| 目的 观察宫颈癌患者调强放疗（IMRT）联合顺铂治疗疗效及不良反应。方法 回顾性分析100例宫颈癌患者，按治疗方法不同分为单纯治疗组和联合治疗组，每组各50例，均给予IMRT外照射，总剂量为50 Gy，2 Gy/次，共25次，5次/周；外照射2周时开始行内照射，1次/周，6~7 Gy/次，共6~8次，总剂量为42~48 Gy。联合治疗组加顺铂同步化疗，静脉滴注，1次/周，30~40 mg/m2，连用4~5周。观察近期疗效和1、3、5年生存率，局部控制率、远处转移率和无瘤生存率，并评价两组患者的不良反应。结果 联合治疗组与单纯治疗组比较，近期疗效及1年生存率，局部控制率、远处转移率、无瘤生存率无明显差异，联合治疗组的3年与5年生存率、局部控制率、远处转移率、无瘤生存率均优于单纯治疗组（χ2=3.843、4.336、4.336、4.960，P<0.05；χ2=3.934、4.454、4.000、4.244， P<0.05）。联合治疗组放射性直肠炎、白细胞总反应率高于单纯治疗组（χ2=4.110、4.320，P<0.05），两组膀胱炎、贫血、血小板总反应率比较无差异，均未出现3~4级直肠炎和膀胱炎。结论 IMRT联合顺铂同步化疗治疗宫颈癌比单纯IMRT疗效好。 |
| 英文摘要: |
| Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix. Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only(IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group), with 50 cases in each. Both groups were treated with external intensity modulated radiotherapy, with the total dose of 50 Gy, 2 Gy/fraction, 25 fractions in total, and 5 times/week. Two weeks later, internal radiotherapy followed, with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction. When the internal radiotherapy began, the external radiotherapy stopped immediately. The combination group was treated concurrently with cisplatin given by intravenous drip once a week, at the dose of 30-40 mg/m2 body surface area for 4-5 weeks, and with total cisplatin dosage of 50-65 mg. Follow-up was conducted for 18 months(3-60 months). The 1-, 3-, and 5-year survival rates, local control rate, distant metastasis rate, and disease-free survival rate, blood test,rectum, and bladder were observed. Results The 1-year survival rate, local control rate, distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups, however,the 3-and 5-year survival rates, local control rates, distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (χ2=3.843,4.336,4.336,4.960,P<0.05; χ2=3.934,4.454,4.000,4.244, P<0.05). The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (χ2=4.110,4.320, P<0.05), whereas the incidence rates of cystitis, anemia, and thrombocytopenia were not significantly different between these 2 groups. No serious grade 3-4 proctitis and cystitis were observed in these 2 groups. Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group. |
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