腔内微波热疗联合放射治疗对老年宫颈癌的疗效观察

Clinical Observation of Intracavitary Microwave Hyperthermia combined with Radiotherapy for Aged Cervical Cancer

目的观察腔内微波热疗加放射治疗对老年宫颈癌的临床疗效。方法收集我院2002年～2006年诊治的老年宫颈癌患者共40例。其中腔内微波热疗加放射治疗组20例，单纯放射治疗组20例。两组放射治疗方法相同，均采用8Mv—X线全盆腔外照射DT30Gy，盆腔四野DT20Gy，加^192Ir高剂量率腔内后装治疗，A点DT42Gy。热疗采用915MHz微波热疗仪，腔内加温43℃～45℃，每次45rain，每周1～2次，共7～10次。结果在肿瘤局部控制率、治疗后CD4／CD8比值、自然杀伤细胞数、2年肿瘤无进展生存率及3年生存率等方面，热疗加放射治疗组均优于单纯放射治疗组，骨髓抑制及放射性直肠炎发生率热疗加放射治疗组明显低于单纯放射治疗组，差异均具有统计学意义（P〈0．05）。结论腔内微波热疗联合放射治疗能提高老年宫颈癌患者的近期及远期疗效．不良反应小。

Objective To evaluate the clinical effect of intracavitary microwave hyperthermia combined with radiotherapy for aged cervical cancer. Methods 40 aged patients with cervical cancer were studied：20 patients treated by radiotherapy plus microwave hypertherthermia,20 patients treated by radiotherapy alone. Radiotherapy of both groups were alike ： a midplane dose of 30Gy to the whole pelvis and 20 Gy to the parametrical areas were given by using 8Mv -X rays, combined with 42 Gy with 192Ir high dose rate therapy. The temperature was increased and maintained at 43 - 45℃ for 45 minutes, once or twice a week for 7 - 10 times. Results The rates of local control 、the level of CD4/CD8 and NK cells after being treated ,the rates of 2 - year disease - free survival and 3 -year survival were higher in the group with radiotherapy plus microwave hypertherthermia than the group with radiotherapy alone （ P 〈 0.05） ; the rates of bone marrow inhibition and radiation proctitis were lower in the former group than the latter group. Conclusion Intracavitary microwave hyperthermia combined with radiotherapy can improve short - term and long - term effects in aged patients with cervical cancers and there were fewer side effecs.