以三维适形放疗推量的宫颈癌治疗的初步研究

Clinical study of cervical cancer treated with more dose by the three dimensional conformal radiation(3-DCRT)without afterloading irradiation

目的:研究宫颈癌去除后装腔内治疗以三维适形放疗推量的可行性、治疗效果及对直肠膀胱并发症发生的影响。方法:60例宫颈癌,随机分组,去除后装组(观察组)26例,外照射结合后装组(对照组)34例。大野照射40Gy/20次后,观察组缩野三维适形照射,总剂量65～70Gy左右,不超过75Gy;对照组中央铅挡盆腔照射给宫旁补量,使外照射B点剂量达45～50Gy;后装治疗补充A点剂量30Gy左右(4～7.5Gy/次,1～2次/周)。结果:两组近期疗效确切,观察组急性消化道发生率低,泌尿系反应发生率相似,观察组反应相对较轻。结论:宫颈癌去后装三维适形放疗可以明显减少急性放射性直肠炎、膀胱炎的发生,近期疗效确切。

Objectlve：To evaluate the feasibility and the therapeutic effect which the cervical cancers obtained more dose by the dimensional conformal radiation （3 -DCRT） without afterloading irradiation,and complications of rectum or bladder . Methods： Sixty cases of cervical cancers were randomly allocated into two groups . The test group（ 26 cases ,3 - DCRT ）, the control group（ 34 cases , external radiation and afterloading irradiation） . After received 40Gy/20 fractions of external radiation to the whole pelvic , Patients in the test group were reduced radiation fields by 3 -DCRT, the total dose 65 -70Gy in general , no more than 75Gy,in the control group received 45 - 50Gy external radiation to the parametrrium, and point A received 30Gy by afterload irradiation（ 4 - 7.5Gy per fraction, 1 -2 fractions per week）. Results： The effect of the 2 groups were affirmative , the rates of acute complication for the rectum were significantly lower in the test group than in the control group , the rates of complication for the bladder were simillar , and the response of the test group was slightly. Conclusion ： The 3 - DCRT without afterloading irradiation of cervical cancer may decrease the complication for rectum or bladder and the short - term effect is affirmative.