放射治疗联合热疗与否对宫颈癌临床疗效的随机观察

Radiotherapy combined with thermotherapy for cervical carcinoma:a randomized trial

目的:观察放射治疗联合热疗对宫颈癌的疗效。方法:60例病理确诊为宫颈癌的Ⅱb~Ⅲb期患者随机分为观察组和对照组。两组的放射治疗方法均为加速器体外照射+铱-192源腔内治疗,外照射剂量总剂量50Gy,2Gy/d,5次/周,腔内照射A点总剂量40Gy,8Gy/次,1次/周。观察组加用微波腔内热疗,宫颈表面温度41~43℃,持续20~30min,每次热疗均在放疗后40~50min内开始,1次/周。治疗结束及结束后3、6、12个月进行CT及妇检,评价疗效。结果:①治疗结束时,两组患者完全缓解(CR)分别为21例和12例(P<0.05),部分缓解分别为(PR)8例和15例(P>0.05)。②随访观察3、6、12个月时,两组患者CR例数分别为28、27、24例和20、18、14例(P<0.05),PR例数分别为2、3、3例和8、8、6例(P>0.05)。结论:放疗热疗联合应用能提高中晚期宫颈癌的远期疗效。

Objective. To evaluate the efficacy of radiotherapy combined with thermotherapy in the treatment of cer^-ical carcinoma. Methods. Sixty patients with stage Ⅱ b-- Ⅲb cervical cancer identified by histology were randomly divided into observation group and control group. For every patient, radiotherapy was performed with daily external irradiation dose of 2 Gy （5 days per week, for 5 weeks）, and intracavitary irradiation for the point A with a total dose of 40 Gy （8 Gy every time, once a week）. The patients in observation group were treated with additional thermotherapy, which was given within 40 to 50 minutes after radiotherapy and sustained for 20 to 30 minutes （once a week）. The temperature of the cervix surface was 41 to 43 ℃. The gynecological examination and CT scans were performed for evaluation of therapeutic effect 3, 6, 12 months after treatment and at the end of the treatment. Results： At the end of the treatment, the complete response （CR） was observed in 21 patients in observation group and 12 in control group （P〈0.05）, and partial response （PR） in 8 and 15 respectively （P〉0.05）. Three, six and twelve months after treatment, the CR was found in 28, 27, 24 patients in observation group and 20, 18, 14 in control group respectively （P〈0.05）, and the PR in 2, 3, 3 in observation group and 8, 8, 6 in control group respectively （P〉 0. 05）. Conclusion. Radiotherapy combined with thermotherapy can improve the therapeutic efficacy of advanced cervical cancer.