期刊文献+

三维放疗联合顺铂同期化疗局部晚期宫颈癌疗效分析 被引量:14

Therapeutic efficacy of three-dimensional conformal radiotherapy combined with concurrent weeklycisplatin-based chemotherapy for locally advanced cervical cancer
原文传递
导出
摘要 目的分析CT图像为基础三维适形放疗联合顺铂同期化疗对晚期宫颈癌患者疗效及副反应情况。方法回顾分析2007--2008年本科收治的181例Ⅱ。~Ⅳ。期宫颈癌患者资料,其中年龄32~82岁(中位数50岁)。放疗采用以CT图像为基础的三维适形放疗和三维^192。Ir后装照射技术,同期联合顺铂单药每周化疗方案。结果随访中位数34个月,随访率为92.2%。全组患者3年总生存率为73.4%、无瘤生存率为70.4%、盆腔控制率为91.3%。肿瘤直径≥4cm和〈4cm者总生存率分别为66.9%和86.4%(X^2=6.29,P=0.012)。RTOG分级急性胃肠道副反应1、2级发生率分别为40.0%、45.O%,泌尿系副反应1、2级发生率分别为19.9%、4.4%。RTOG分级晚期下消化道副反应3+4级发生率为4.9%。结论以CT图像为基础三维适形放疗和三维^192Ir后装照射技术联合顺铂同期化疗对局部晚期宫颈癌患者疗效较好,并对降低晚期严重副反应的发生有益。 Objective To analyze the therapeutic efficacy and treatment related toxicities for patients with locally advanced cervical cancer treated with three-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy. Methods From January 2007 to February 2008, 181 patients with stage IIA-IVA cervical cancer were retrospectively analyzed. All patients were treated with CT- based three-dimensional external beam and 192Ir intraeavity radiotherapy combined with concurrent weekly cisplatin-based chemotherapy. The median age was 50 years (range, 32 to 82 years). The overall survival (OS), disease-free survival (DFS) and local control (LC) rates were calculated by Kaplan-Meier method and the difference was compared using Log-rank test. The treatment related toxieities were evaluated according to Radiotherapy Oncology Group (RTOG) criteria. Results With a median follow-up time of 34 months and following rate of 92. 2% , the 3-year OS, DFS and LC rates were 73.4%, 70. 4% and 91. 3%, respectively. The 3-year OS rate was 66. 9% for patients with tumor diameter 1〉4 cm and 86.4% for those with tumor diameter 〈4 cm (X^2 =6. 29,P =0. 012). The incidences of grade 1 and grade 2 acute toxicities of the lower gastrointestinal tract and the genitourinary system were 40. 0% ,45.0% and 19. 9% ,4. 4%, retrospectively. There were no grade 3 or more acute toxicities. The incidence of grades 3 or 4 late toxicities of the lower gastrointestinal tract was 4. 9%. Conclusions CT-based three-dimensional external beam and 192 Ir intracavity radiotherapy combined with concurrent chemotherapy can achieve good therapeutic effects for locally advanced cervical cancer. The acute and late toxieities are significantly reduced compared with historic controls as a result of incorporation of 3DCRT technique.
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2011年第2期144-148,共5页 Chinese Journal of Radiation Oncology
基金 国家高技术研究发展计划(863课题)(2007AA022437)
关键词 宫颈肿瘤/放化疗法 放射疗法 三维适形 化学疗法 同期 预后 Cervical neoplasms/radiochemotherapy Radiotherapy,three-dimensional conformal Chemotherapy,concurrent Prognosis
  • 相关文献

参考文献13

  • 1I Benedet JL, Hacker NF, Ngan HYS, eds. Joint FIGO-IGCS Staging classification and clinical practice guidelines for gynecological cancers. 2 ed. Amsterdam : Elsevier,2003:45-47.
  • 2Green JA, Kirwan JM, Tierney JF, et al. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis. Lancet, 2001,358:781-786.
  • 3李斌,安菊生,吴令英,徐英杰,戴建荣,黄曼妮,高菊珍.子宫颈癌术后盆腔不同体外照射方法的剂量学研究[J].中华放射肿瘤学杂志,2008,17(3):211-215. 被引量:40
  • 4Kirisits C, P~tter R, Lang S, et al. Dose and volume parameters for MRI-based treatment planning in intracavitary brachytherapy for cervical cancer. Int J Radiat Oncol Biol Phys ,2005,62:901-911.
  • 5Wachter-Gerstner N, Wachter S, Reinstadler E, et al. Bladder and rectum dose defined from MRI based treatment planning for cervix cancer brachytherapy : comparison of dose-volume histograms for organ contours and organ wall, comparison with ICRU rectum and bladder reference point. Radiother 0ncol,2003,68:269-276.
  • 6Haie-Meder C, Pfitter R, Van Limbergen E, et al. Recommendations from gynaecological (GYN) GEC-ESTRO working group (I) : concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol,2005,74: 235-245.
  • 7Viswanathan AN, Erickson BA. Three-dimensional imaging in gynecologic brachytherapy : a survey of the American brachytherapy society. Int J Radiat Oncol Biol Phys,2010,76 : 104-109.
  • 8Spensley S, Hunter RD, Livsey JE, et al. Clinical Outcome for chemoradiotherapy in carcinoma of the cervix. Clin Oncol, 2009, 21:49-55.
  • 9Pearcey R, Brundage M, Drouin P, et al. Phase Ⅲ trial comparing radical radiotherapy with and without cisplatin chemotherapy in patients with advanced squamous cell cancer ofthe cervix. J Clin 0ncol,2002,20:966-972.
  • 10Kirwan jM, Symonds P, Green JA, et al. A systematic review of acute and late toxicity of concomitant chemo-radiation for cervical cancer. Radiother 0ncol,2003,68:217-226.

二级参考文献13

  • 1International Commission on Radiation Units and Measurements. Report 62. Prescribing, Recording, and Reporting Photon Beam Therapy ( supplement to ICRU Report 50 ). Bethesda: ICRU, 1999.
  • 2McAlpine J,Schlaerth JB, Lim P, et al. Radiation fields in gynecologic oncology: correlation of soft tissue ( surgical ) to radiologic landmarks. Gynecol Oncol,2004,92:25-30.
  • 3Sedlis A,Bundy BN,Rotman MZ,et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a gynecologic oncology group study. Gynecol Oncol, 1999,73 : 177-183.
  • 4Roeske JC, Lujan A, Rotmensch J,et al. Intensity-modulated whole pelvis radiation therapy in patients with gynecologic malignancies. Int J Radiat Oncol Biol Phys, 2000,48 : 1613 -1621.
  • 5D'Souza W, Ahamad A, Iyer R, et al. Feasibility of dose escalation using intensity-modulated radiotherapy in posthysterectomy cervical carcinoma. Int J Radiat Oncol Biol Phys,2005,61:1062-1070.
  • 6Ahamad A, D'Souza W, Salehpour M, et al. Intensity-modulated radiationtherapy(IMRT) after hysterectomy: Comparison with conventional treatment and sensitivity of the normal-tissue-sparing effect to margin. Int J Radiat Oncol Biol Phys, 2005,62 : 1117- 1124.
  • 7van de Bunt L,van der Heide UA,Ketelaars M,et al. Conventional, conformal, and intensity-modulated radiation therapy treatment planning of external beam radiotherapy for cervical cancer: The impact of tumor regression. Int J Radiat Oncol Biol Phys,2006, 64 : 189-196.
  • 8Heron DE, Gerszten K, Selvaraj RN, et al. Conventional 3 D conformal versus intensity-medulated radiotherapy for the adjuvant treatment of gynecologic malignancies : a comparative dosimetric study of dose-volume histograms small star,filled. Gynecol Oncol,2003, 91,39-45.
  • 9Taylor A, Rockall AG, Reznek RH, et al. Mapping pelvic lymph nodes : guidelines for delineation in intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys,2005,63:1604-1612.
  • 10Kaatee RS, Olofsen M J, Verstraate MB, et al. Detection of organ movement in cervix cancer patients using a fluoroscopic electronic portal imaging device and radiopaque markers. Int J Radiat Oncol Biol Phys ,2002,54 : 576-583.

共引文献39

同被引文献95

  • 1Ibtihal Fadhil,Batool Hasan G.Baqer,Fatima Faisal Al Hlwachi,Eman Ahmed Dashti,Nawara Essam BehzadAmina A.Jabbar A.Karim,Samara Al Reefy.Factors associated with cervical cancer knowledge and practice among Bahraini women[J].Asian Pacific Journal of Tropical Medicine,2008,1(3):72-78. 被引量:1
  • 2刘华顶,王世亮,武四化,储成顶,俞敏,吴静.缓释氟尿嘧啶植入剂在大肠癌患者的药动学研究[J].中国新药杂志,2005,14(10):1199-1201. 被引量:44
  • 3廖小方,郑勤红,何慧娟,胡伟.每日低剂量顺铂同步放疗非小细胞肺癌临床研究[J].中华放射肿瘤学杂志,2006,15(3):232-233. 被引量:7
  • 4孙建衡,蔡树模,高永良.妇科肿瘤学[M].北京:北京大学医学出版社,2011:2-10.
  • 5Green J, Kirwan J, Tierney J,et al. Concomitantchemotherapy and radiation therapy for cancer of theuterine cervix [J]. Cochrane Database Syst Rev,2005,20(3):2 225.
  • 6Sensely S,Hunter R D,Livsey J E,et al. ClinicalOutcome for chemoradiltherapy in carcinoma of thecetvix[J]. Clin Oncol,2009,21(1) :49 — 55.
  • 7Pecorelli S.Revised FIGO staging for carcinoma of the vulva,cervix,and endometrium[J].Int J Gynaecol Obstet,2009,105(2):103-104.
  • 8WHO handbook for reporting results of cancer treatment[M].Offset Publication No.48.Geneva (Switzerland):World Health Organization,1979.
  • 9Cox JD,Stetz J,Pajak TF.Toxicity criteria of the radiation therapy oncology group (RTOG) and the European Organization for research and treatment of cancer(EORTC)[J].Int J Radiat Oncol Biol Phys,1995,31 (5):1341-1346.
  • 10Arai T,Nakano T,Morita S,et al.High-dose-rate remote afterloading intracavitary radiation therapy for cancer of the uterine cervix.A 20-year experience[J].Cancer,1992,69 (1):175-180.

引证文献14

二级引证文献48

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部