高剂量率^(192)Ir腔内近距离加体外照射治疗宫颈癌

High-dose-rate ^(192)Ir brachytherapy combined with external irradiation therapy for cancer of the uterine cervix

目的：回顾分析高剂量率１９２Ｉｒ近距离治疗加体外照射治疗宫颈癌的疗效及生存率。 方法： １９９３年５月至１９９７年５月，５４例子宫颈癌采用高剂量率１９２Ｉｒ近距离加体外照射治疗，其中Ⅰ期２例，Ⅱ期２９例，Ⅲ期２１例，Ⅳ期２例。体外和腔内照射Ａ点总量为６５～８５Ｇｙ，Ｂ点剂量５０～７０Ｇｙ，治疗时间６～８周。 结果：本组总的１、３、４年生存率８１．５％、６８．５％、６１．１％。Ⅰ、Ⅱ、Ⅲ、Ⅳ期４年生存率分别为１００％、７５．９％、４２．８％和０％，临床分期是决定预后的重要因素。放射性直肠炎及放射性膀胱炎发生率分别是３１．５％和１１．１％。结论： 宫颈癌的腔内与体外放射治疗是其有效的治疗手段，但如何进一步提高治愈率，降低并发症仍是今后研究的方向。

Objective: To analyze retrospectively results of cervix carcinoma treated by high dose rate 192Ir intracavitary brachytherapy and external irradiation. Methods: From May 1993 to May 1997，54 cases of cervix carcinoma were treated by combined external radiation with brachytherapy . The patient population consisted of 2 cases with stageⅠ disease , 29 cases with stage Ⅱ disease , 21 cases with Stage Ⅲ disease and 2 cases with stage Ⅳ disease . The total dose of the external and intracavitary irradiation at point A and B was 65～85Gy and 50～70Gy ，respectively. The total treatment time was 6～8 weeks . Results: The survival rate of 1、3、4 year after radiotherapy was 81.5%，68.5% and 61.1% ，respectively. The 4-year survival for stages Ⅰ、Ⅱ、Ⅲ and Ⅳdisease were 100%、75.8%、42.8% and 0% , respectively .The clinical stage of disease is an important prognostic factor . The incidence of complication was 31.5% for radiation proctitis and 11.1% for cystitis. Conclusion:HDR brachytherapy with external irradiation for the cervix carcinoma is an effective method. To improve tumor control and reduce complication rate more research is necessary.