46例盆腔肿瘤术后局部复发患者同步加量静态调强放疗的临床观察

Clinical Analysis of 46 Patients with Pelvic Recurrence Tumor After Operation Using Static Intensity Modulated Radiotherapy with Simultaneous Boost Dose

目的观察同步加量静态调强放疗技术对盆腔肿瘤术后局部复发患者的疗效和不良反应。方法回顾分析2007～2009年收治的46例盆腔肿瘤术后局部复发患者(直肠癌、宫颈癌、膀胱癌患者分别为20、17、9例)临床资料,结合三维适形放疗文献结果加以比较,对初步疗效和不良反应加以讨论。结果中位随访时间21.6个月,随访率100%。全组完全缓解率、部分缓解率和有效率分别为39.1%、56.5%和95.6%,其中直肠癌患者分别为15.0%、80.0%和95.0%,宫颈癌患者分别为58.8%、35.3%和94.1%,膀胱癌患者分别为55.5%、44.4%和100%。全组1、2年总生存率分别为88.2%、62.3%,其中直肠癌患者分别为90.8%、67.6%,宫颈癌患者分别为62.5%、39.1%,膀胱癌患者分别为100%、100%。不良反应较轻,治疗结束后好转。结论同步加量静态调强放疗技术比三维适形放疗对盆腔肿瘤术后局部复发患者的近远期疗效好,不良反应轻,与三维适形放疗+化疗的结果相似。但最终结论还需大样本前瞻性对照组研究加以证实。

Objective To observe curative effect and side - responses in patients with pelvic recurrence tumor after operation using static intensity modulated radiotherapy with simultaneous boost dose. Methods From 2007 to 2009,46 patients with pelvic recurrence tumor after operation were retrospectively analyzed,with thereinto rectum carcinoma 20 patients, uterine cervical carcinoma 17 patients and bladder carcinoma 9 patients. And their clinical data were compared with three - dimensional conformal radiotherapy results combined with literature. The primary results using static intensity modulated radiotherapy with simultaneous boost dose were analyzed. Results The median followup time was 21.6 months. The follow -up rate was 100%. The over completeness responses rate, proportion responses and efficiency rate wore 39.1% ,56.5% and 95.6% in 46 patients with pelvic recurrence tumor after operation; thereinto 15.0%, 80.0% and 95.0% in rectum carcinoma patients, 58.8% , 35.3% and 94.1% in uterine cervical carcinoma patients and 55.5% , 44.4% and 100% in bladder carcinoma patients. The 1 - and 2 - year overall survival rate were 88.2% and 62.3% in 46 patients with pelvic recurrence tumor after operation; thereinto 90.8% and 67.6% in rectum carcinoma patients,62.5% and 39.1% in uterine cervical carcinoma patients and 100% and 100% in bladder carcinoma. The side - responses were obvious light and became weaken after radiotherapy. Conclusion These primary results show that curative effects are good and side - responses are obvious light for patients with pelvic recurrence tumor after operation using static intensity modulated radiotherapy with simultaneous boost dose compared with three - dimensional conformal radiotherapy. But these results are similitude compared with three - dimensional conformal radiotherapy plus chemotherapy. Yet finally conclusions are confirmed by large patients preceding control study.