摘要
目的探讨调强放射治疗(IMRT)治疗复发性宫颈癌的近期疗效及并发症的发生情况。方法回顾性分析38例盆腔复发和腹膜后淋巴结转移的宫颈癌患者采用IM- RT放疗的临床资料,其中复发前接受单纯手术20例、单纯放疗8例、手术后辅助放疗者10例,采用6my-X线5～9野照射,曾经接受放疗的患者给予处方剂量95% PTV50GY,无放疗史患者给予处方剂量95%PTV70GY,分割2GY/次,每周5次,共25～35次完成,放疗后3个月评估疗效,并将曾经接受放疗的患者(18例)与单纯手术患者(20例)进行对比,观察两组患者的近期疗效和放疗并发症的发生情况。结果下肢水肿、腰腿疼痛症状缓解率100%,肾盂积水缓解率75%(9/12),3个月疗效评估:完全缓解率65.8%(25/38),部分缓解率13.1%(5/38),稳定率10.5%(4/38),进展率10.5%(4/38),有效率78.9%(30/38)。曾经接受根治性放疗和术后放疗与单纯手术比较有效率分别为61%(11/18)(P=0.016)和95%(19/20),近期毒副作用主要为骨髓抑制,≥Ⅲ度31.6%(12/38),胃肠道和泌尿系反应均为Ⅰ～Ⅱ度。结论IMRT放疗治疗复发性宫颈癌,能很好地缓解症状,近期疗效高,对于复发性宫颈癌IMRT放疗是一种有效的方法。
Objective To discuss the early clinical results and complications of intensity-modulated radiotherapy （IMRT） for recurrent uterine cervical cancer. Methods The clinical data of 38 uterine cervical cancer patients with pelvic recurrence and retroperitoneal lymph nodes metastasis who had undergone IMRT were reviewed. Primary treatments included surgery alone （20 cases）, radiotherapy alone （8 cases）, and surgery combined with radiotherapy （ 10 eases）. Five-to nine-field IMRT plans were performed with 6 mv X ray. Prescription dose for 95 percent of FIT （Planning Target Volume） was 50 Gy for patients received RT before, and 70 Gy for those without, in 25 to 35 fractions with a fractionated dose 2 Gy per day, five days per week. Therapeutic effects were estimated three months after IMRT and effects and complications incidence were compared between patients with surgery alone before and those with RT alone. Result Remission rate for oedema legs and lumbago and leg pain was 100%, and for hydrone-phrosis was 75% （9/12）. At the therapeutic effects estimation three months after IMRT, complete remission rate was 65.8% （25/38）, partial remission rate 13. 1% （5/38）, stable disease rate 10. 5% （4/38）, progressive rate 10. 5% （4/38）, and a total response rate 78. 9% （30/38）. Total response rate for patients with surgery alone before and those with RT were 95% （19/20） vs. 61% （11/18） （ P =0. 016）. The critical early complications were marrow depression Ⅲ In· 31.6% （12/38）, and were I - Ⅱ° in gastrointestinal or urinary system. Conclusions IMRT is feasible in treating of recurrent cervical cancer for its good symptoms remission rate and high early therapeutic response rate.
出处
《癌症进展》
2008年第5期449-453,共5页
Oncology Progress
