张芹,王晗.宫颈癌术后限定骨髓剂量盆腔调强放疗的临床研究[J].中华放射医学与防护杂志,2015,35(6):441-444.Zhang Qin,Wang Han.Clinical study of bone marrow-sparing intensity-modulated radiation therapy for postoperative cervical cancer[J].Chin J Radiol Med Prot,2015,35(6):441-444 |
宫颈癌术后限定骨髓剂量盆腔调强放疗的临床研究 |
Clinical study of bone marrow-sparing intensity-modulated radiation therapy for postoperative cervical cancer |
投稿时间:2014-11-27 |
DOI:10.3760/cma.j.issn.0254-5098.2015.06.009 |
中文关键词: 宫颈癌 限定骨髓剂量 调强放疗 不良反应 |
英文关键词:Cervical cancer Bone marrow-sparing Intensity-modulated radiation therapy Toxicity reaction |
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中文摘要: |
目的 观察宫颈癌患者术后限定骨髓剂量的盆腔调强放疗(BMS-IMRT)与非限定骨髓剂量的盆腔调强放疗(IMRT)联合化疗的近期疗效及不良反应。方法 本院宫颈癌术后患者70例,用抽签方法随机分为BMS-IMRT组34例和IMRT组36例,行盆腔外照射调强放疗联合化疗,计划靶体积剂量45 Gy分25次。BMS-IMRT组勾画骨盆并给予单独限量:骨盆V30≤50%;70例患者同期每周40 mg/m2顺铂化疗。结果 除3例因重度骨髓抑制未完成化疗外,67例患者顺利完成治疗。两组2年的局部控制率及生存率、下消化道及泌尿系统不良反应差异无统计学意义,BMS-IMRT组血液学不良反应较IMRT组轻,差异有统计学意义(χ2=14.355,P<0.05)。结论 宫颈癌术后行盆腔同步放化疗患者,BMS-IMRT组较IMRT组血液学不良反应减轻,近期疗效及其他放疗不良反应无明显差异。 |
英文摘要: |
Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy(BMS-IMRT) for postoperative cervical cancer. Methods From January 2011 to June 2012, totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly. External whole pelvic intensity-modulated irradiation combined with chemotherapy was carried out for all patients. The planning target volume received a dose of 45 Gy/25 fractions in all patients. Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group: the pelvis V30≤50%. All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy. Results Treatment was completed in 67 patients, as the other 3 patients stopped chemotherapy because of myelosuppression. There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS), alimentary tract toxicity and urinary toxicity. IMRT group had more serious hematologic toxicity than BMS-IMRT group, with statistically significant difference (χ2=14.355, P<0.05). Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy, IMRT group has more serious hematologic toxicity than BMS-IMRT group. The short-term effect and other toxicities reaction are similar between two groups. |
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