Ⅱ期巨块型宫颈癌术前15Gy体外放疗近期临床疗效探讨

Short-term curative effect of external irradiation of 15Gy plus operation for bulky stage Ⅱcervical carcinoma

目的:探讨Ⅱ期巨块型宫颈癌术前大放疗量体外冲击放疗加手术治疗的临床疗效.方法:对30例Ⅱ期巨块型宫颈癌患者根治术前连续3次进行大放疗量5 Gy体外放疗,对患者的局部肿瘤缓解情况、毒副反应及手术情况进行回顾性分析;与直接接受根治术的同期别20例巨块型宫颈癌比较.结果:行体外15 Gy放疗后,临床完全缓解(CR)和部分缓解(PR)分别是3.3%(1/30)和73.3%(22/30),无变化(SD)与恶化(PD)分别为23.3%(7/30)和0.放疗并发症发生率低,体外放疗组较直接手术组手术时间缩短,术中出血量减少,尿潴留的发生率低,两组比较差异有显著性.高危病理差异无显著性.结论:①术前体外5 Gy/f×3f放射治疗对Ⅱ期巨块型宫颈癌具有较好的缩减瘤体效果,放疗并发症少.②体外放疗后5～7 d行手术治疗在手术时间及术中出血量与直接手术组患者相比均有明显下降,且不增加术后并发症.

AIM： To evaluate the curative effect of preoperation high-dose-rate external irradiation plus operation for bulky stage Ⅱ cervical carcinoma. METHODS：A retrospective review was performed of 30 patients with bulky stage Ⅱ cervical carcinoma treated by 5 Gy × 3D external irradiation before operation. Compared with 20 cases of bulky cervical cancer of the same stage only recepted radical hysterectomy. RESULTS： In the external irradiation group, the clinical complete remission （CR） , partial remission （ PR）, stable diameter （ SD ） and progression disease （PD） were 3. 3%, 73. 3%, 23. 3%, and 0, respectively. Incidence of radiotherapy complication was low. The subsequent surgery went well. Operation time and blood loss decreased significantly, post-operative complication as urinary retention was significantlylower than the only operation group. No significannt difference in high-risk pathology. CONCLUSION ： 5 Gy/f × 3f external irradiation before operation can well diminute the tumor of bulky stage Ⅱ cervical carcinoma, lower incidence of complication, not to increase intraoperative and postoperative complications.