高、低剂量率腔内放疗在宫颈癌治疗的比较

LOW DOSE RATE VERSUS HIGH DOSE RATE BRACHYTH ERAPY IN THE TREATMENT OF CARCINOMA OF THE UTERINE CERVIX

回顾性分析高剂量率 (HDR)和低剂量率 (LDR)腔内放射治疗宫颈癌。前者疗效低于后者(Ⅲ期明显 ) ,但与国际两种治疗方法比较 ,HDR组疗效与之相似 (Ⅱ期稍好 )。HDR组Ⅱ、Ⅲ级放射性直肠炎发生率明显低于LDR组 (P <0 .0 1 ) ,而放射性膀胱炎和直肠阴道瘘的发生率两组间无差别 (P >0 .0 5 )。两组Ⅱ、Ⅲ期患者中无癌存活 5年以上者宫旁A点吸收量比值 (HDR/LDR)为 0 .5 3～ 0 .5 5。此剂量率转换系数对指导临床实践有参考价值。

This study is a retrospective non-randomized clinical evaluation undertaken at our hospital to compare low dose rate(LDR) versus high dose rate(HDR) intracavitary brachytherapy in the treatment of carcinoma of the uterine cervix. The survival in HDR group was lower than that in LDR group, especially for stage 3. The incidence of Grade 3～4 rectal complications was significantly less in HDR than in LDR groups(P<0.01). The ineidences of radiocystitis and rectalvaginal fistula were not significantly differe in both groups (P>0.05). The total dose to pointA in HDR group for stage 2～3 was reduced with an average HDR/LDR ratio of 0.53～0.55. This factor might be benefitial in guiding clinical practice.