宫颈癌术前行组织间插植放疗治疗价值探讨(附20例报告)

THE EVALUATION OF INTERSTITIAL IMPLANT BRACHYTHERAPY IN PREOPERATIVE MANAGEMENT OF CERVICAL CARCINOMA

目的 :探讨组织间插植近距离放疗在宫颈癌术前的治疗价值。方法 :对A组 ( 2 0例 )宫颈癌Ⅰb2 期根治术前曾行组织间插植放疗患者的局部肿瘤临床、病理缓解情况的资料进行回顾性分析 ,并与B组 ( 2 0例 )仅行宫颈癌根治术的宫颈癌患者 (Ⅰa2 -Ⅰb1期 )在术后组织病理、平均手术时间、出血量、手术损伤、术后尿潴留等指标上进行比较分析。结果 :从 1999年 12月～ 2 0 0 0年 12月接受组织间插植近距离放疗宫颈癌Ⅰb2 期患者 2 0例 ,宫颈局部肿瘤的临床完全缓解、部分缓解、病理学完全缓解、部分缓解分别为 10 0 %、0 %、6 8%、32 % ;A组与B组比较 ,两组病理学、平均手术时间、平均出血量、手术损伤、淋巴结转移、术后尿潴留情况无显著性差异 (P >0 0 5 )。结论 :组织间插植近距离放疗对宫颈癌 (菜花型 )患者可改善局部情况 ,缩小肿瘤体积 ,提高手术切除率 ,降低癌细胞活性 ,不增加肿瘤远处转移 ,无放疗并发症 。

OBJECTIVE:To evaluate interstitial implant brachytherapy in preoperative management of cervical carcinoma. METHOD:Group A:20 patients with cervical carcinoma I b2 received interstitial implant brachytherapy before operation.Retrospective analysis of clinical and pathological response of their cervical neoplasm was made.Group B:20 patients with cervical carcinoma I a2 -I b1 only received cervical cancer radical operation (CCRO).A comparative analysis between Group A and Group B were made in pathology,mean of operation time and amount of bleeding and injury of operation etc.RESULTS:Among the 20 patients receiving the therapy during February 1999 to February 2000,100% were completely remitted clinically and 68% completely remitted as well as 32% partly remitted pathologically.There was no difference between Group A and B (P>0 05).CONCLUSION:Intersititial implant brachytherapy is a effect way to improve local condition and reduce size of tumor and activity of cancer cells.It can increases opportunity of tumor incision without causing distant metastasis and complications,thus to increase curative rate of cervical carcinoma.