后程三维适形放疗在Ⅱb～Ⅳa期宫颈癌中的应用

Later Course three-dimensional conformal radiotherapy for stage Ⅱb-Ⅳa cervical carcinoma

目的探讨三维适形放射治疗宫颈癌的疗效,并与传统腔内放疗比较。方法将64例Ⅱb～Ⅳa期宫颈癌患者随机分为对照组和研究组,对照组30例为腔内后装放疗;研究组34例为后程适形放疗。结果对照组和研究组总有效率及1、2、3年生存率分别为96.7%、86.7%、66.7%、56.7%和97.1%、91.2%、70.6%、64.5%,两组比较差异无统计学意义(P>0.05);两组的早期并发症(直肠反应、阴道炎)、晚期并发症(放射性直肠炎、放射性膀胱炎)发生率分别为60.0%、46.7%、36.7%、30.0%和35.3%、20.6%、14.7%、8.8%,两组比较差异有统计学意义(P<0.05)。结论Ⅱb～Ⅳa期宫颈癌后程适形放疗与传统腔内照射疗效相似,并发症更低,可替代后者。

Objective To explore the clinical effect of Later Course three-dimensional conformal radiotherapy for stage Ⅱb-Ⅳa cervical carcinoma and compare to that of traditional intracavitary radiotherapy.Methods 64 cases of stage Ⅱb to stage Ⅳa cervical carcinoma were divided into the treatment group and the control group randomly.The treatment group（34 cases）were treated with a combination of external irradiation with 3D-CRT,and 30 cases of the coutrol group were treated with the combination of external irradiation with intracavitary radiation therapy.Results The effective rates of the treatment group and the control group were 96.7 % and 97.1% respectively,with no significant difference（P〉0.05）.1,2,3-year surval rates were 91.2%,70.6%,64.5% and 86.7%,66.7%,56.7% respectively,with no significant difference（P〉0.05）.The rates of short-term and long-term radiation reaction of two groups were different（P〈0.05）.Conclusion The clinical effect of 3D-CRT is similar to that of traditional external radiotherapy in the treatment of cervical carcinoma.The 3D-CRT could supersede the tradition for lower complications rate.