放射治疗结合热疗治疗宫颈癌的近期疗效观察

Evaluation of short-term efficacy of radiotherapy combined with hyperthermia in treatment of cervical carcinoma

目的观察放射治疗加热疗治疗宫颈癌的近期疗效。方法将50例病理诊断明确，临床分期Ⅱb～Ⅲb期的中晚期宫颈癌患者随机分两组，放射治疗＋热疗组（热放组）和单纯放射治疗组（单放组）各25例，两组的放射治疗方法一样，放疗采用加速器体外照射＋^60Co腔内后装治疗，体外照射剂量50Gy／25tY5W（40Gy时放射野中央挡铅），腔内照射A点总剂量40Gy／8f，热疗采用微波腔内热疗，宫颈表面温度41—43％，持续20～30min，每次热疗均在内疗后30min内开始，每周1次，至放疗结束。治疗结束后3个月进行CT及妇检，评价近期疗效。结果热放组和单放组的局部控制率（CR）分别为80．0％和48．0％，部分缓解率（PR）为16．0％和32．0％，两组比较差异有显著性（P〈0．05）。结论放疗热疗联合应用能提高晚期宫颈癌的局部控制率。

Objective To evaluate the short-term efficacy of radiotherapy combined with hyperthermia in treatment of cervical carcinoma. Methods Fifty patients who were diagnosed as stage- b- Ⅲb cervical cancer by pathological method were divided into two groups randomly ：25 patients were treated with radiotherapy plus hyperthermia （ H ＋ R group） and 25 patients were treated with radiotherapy alone （ R group）. Radiotherapy of both groups was alike. Radiotherapy was given with daily external irradiation dose of 2 Gy to the pelvis, 5 d/wk for 5 weeks and intra-cavity braehytherapy to a total dose of 40 Gy to point A. H ＋ R group was treated with additional hyperthermia, which was given 20-30 minutes after radiotherapy, until radiotherapy was over. The temperature of pelvic cavity was 41-43℃. Three months after treatment the patients were examined by CT and gynecologic examination, and the recent curative effect was evaluated. Results The local eontrol rates of H ＋ R group and R group were CR 80. 0% and 48.0%, PR 16.0% and 32. 0% respectively. Conclusion Radiotherapy combined with hyperthermia can improve the short-term therapeutic efficacy of advanced cervical cancer and the patients can endure the side effects.