48例中晚期宫颈癌同步放疗、化疗临床疗效分析

Curative Effect of Synchronous Radio Chemotherapy in Medium-term and Advanced Cervical Carcinoma

目的 探讨同步放疗、放疗治疗中晚期宫颈癌的疗效及毒性反应。方法 48例确诊的II～III期宫颈癌患者采用192Ir高剂量率腔内后装加体外放射治疗,开始体外盆腔照射,5次/周,2Gy/次,盆腔平面中心剂量30～40Gy,3～4周完成;然后中间挡铅,4个野照射,4次/周,2Gy/次,宫旁剂量15～20Gy;同时腔内治疗,1次//周,6Gy/次,剂量36～42Gy;放疗同时用DDP+5～Fu联合化疗;DDP20mg/m2第1～5天,5～Fu750mg/m2第1～5天,4周重复一次,共2～4次。结果 全组病例3、5年生存率83.3%和72.9%。早期放射性直肠反应发生率为10.04%,膀胱反应的发生率为6.2%,晚期放射性直肠炎发生率为14.5%,膀胱炎为6.2%,直肠阴道瘘无一例发生。结论 同期放疗、化疗、治疗中晚期宫颈癌疗效肯定,应用方便,副作用少。

ive Objective To investigate the curative effective and side effect of synchronous inmedium～term and advanced cervical carcinoma. Methods The 48 patients of stage IIb～III cervicalcercinoma were treated with combination of HDR192Ir after loading intracavitary Brach therapy plus EBRT.A midplane dose of 30～40Gy to the whole pelvis and additional 15～20Gy EBRT to the parametrical areaswere given. Intracabitary Brach therapy saw delivered to a total dose of 36～42Gy at 6Gy per fraction,once a week.Each patient was given DDP with combined chemotherapy at the dose of 20mg/m2.From the firstday the fifth day, 5～fu 750mg/m2,The treatment cycle was performed once every 4 weeks for 2～4 times.Results All patients were followed up over five years. The 3～and～5 year survival rates 83.3% and 72.9%. The 5～year survival rates for stage II and stage III lesions were 79.3% and 63.1%(P>0.05).Immediaterectal reaction and late radioproctitis were present in 10.04% and 14.5%,acute and chronic radiationcystitis in 6.2% and 6.2%, respectively.Rectovaginal fistula developed in 0.9%.Conclusion Synchronousradiotherapy and chemotherapy are effective with equitable complications in the treatment of carcinomaof uterine cervix.