调强放疗在早期子宫颈癌术后阴道残端复发治疗中的价值

Evaluation of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery

目的 探讨调强放疗治疗早期子宫颈癌术后阴道残端复发的价值.方法 采用回顾性同期对照研究,对30例早期子宫颈癌术后阴道残端复发患者（试验组）行调强放疗,选择同期行常规放疗的30例早期子宫颈癌术后阴道残端复发患者为对照组,两组均行3个疗程TP方案治疗.比较两组间患者的近期疗效及并发症情况.结果 试验组完全缓解（CR） 22例,部分缓解（PR）7例,进展（PD）1例,对照组CR 14例,PR 5例,稳定（SD）7例,PD 4例,试验组有效率为96.67％（29/30）,对照组有效率为63.33％（19/30）,差异有统计学意义（P=0.009）.试验组1例1级放射性膀胱炎,1例1级放射性肠炎;对照组3例阴道直肠瘘,1例3级放射性膀胱炎,2例2级放射性膀胱炎,2例1级放射性肠炎.结论 调强放疗治疗早期子宫颈癌术后阴道残端复发近期疗效满意,优于常规放疗,不良反应可耐受.

Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy （IMRT）,and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 % （29/30） and 63.33 % （19/30）,respectively,in the experimental and control group,which showed statistical significance （P =0.009）.In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.