7野调强与9野调强的骨髓限量放疗对晚期宫颈癌患者骨髓抑制的影响

The impact of different number of radiation fields on myelosuppression for patients with advanced cervical cancer

目的:分析不同射野数量的骨髓限量调强放疗(BMS-IMRT)对晚期宫颈癌骨髓抑制的影响,以期为临床诊疗提供参考。方法:纳入2015年1月~2016年9月在我院接受放射治疗(BMS-IMRT)的局部晚期宫颈癌患者的临床资料。依据设野数量不同将患者分为观察组(BMS-IMRT7f)及对照组(BMS-IMRT9f)。共纳入观察组患者42例,对照组患者45例。对比两组靶区分布、骨髓抑制发生情况及治疗前后T淋巴细胞亚群改变。结果:两组患者靶区分布指标比较均未见显著差异。两组骨髓抑制发生率比较未见显著差异,但观察组患者Ⅲ~Ⅳ级骨髓抑制发生比例显著低于对照组。观察组患者骨髓OAR受量在V10、V20、V30及V40水平均显著低于对照组。两组患者放疗后CD4+T比例及CD4+T/CD8+T均显著降低,但观察组仍高于对照组。结论:在宫颈癌放疗中,7野调强可达到9野调强相近的靶区剂量分布,而骨髓抑制程度显著低于9野调强。

Objective Our study was aimed to analyze the impact of different number of radiation fields on myelosuppression for patients with advanced cervical cancer.Methods Clinical data of patients with advanced cervical cancer received bone marrow-sparing intensity-modulated radiotherapy(BMS-IMRT)at our hospital from 2015 to 2016 were analyzed.Patients were divided into two groups by different number of radiation fields,Group A:BMS-IMRT7f;Group B:BMS-IMRT9f.Results A total of 87 patients were analyzed,Group A 42 cases,Group B 45 cases.These was no significant difference of target area distribution index between the two groups.These was no significant difference of myelosuppression rate between the two groups,however,the Group A patients had lower myelosuppression rate ofⅢ~Ⅳgrade.The Group A patients had lower bone marrow OAR at V10,V20,V30 and V40 than these of Group B.Both of the two groups got significantly decreased in CD4+T and CD4+T/CD8+T,however,these index were higher in Group A when compared with those of Group B.Conclusion In the treatment of cervical cancer,the BMS-IMRT7f can got similar effect with BMS-IMRT9f,but a mild bone marrow suppression.