微波深部热疗加同步放化疗治疗中晚期宫颈癌的临床效果

Clinical study of microwave hyperthermia plus radiotherapy and chemotherapy in the treatment of advanced cervical cancer

目的:评价微波深部热疗在中晚期巨块型宫颈癌治疗中的疗效及安全性。方法:将经放化疗和放化热疗治疗的100例Ⅱb-Ⅲb期、肿瘤直径大于4cm的巨块型宫颈癌患者各50例,分为对照组和实验组。对照组放化疗:外照射均采用6MV-X加速器调强放射治疗+192铱高剂量率后装腔内照射,同步顺铂40mg/m2,静点,每周1次,与外照射同步结束。实验组:放化疗与对照组相同,另加局部体外热疗,温度为(40±1)℃,60分/次,2次/周,共10次。治疗结束后1个月复查相关检查,进行疗效评价。结果:实验组达到CR者92%(46/50),对照组达到CR者仅78%(39/50),肿瘤缩小率实验组明显高于对照组,差异有统计学意义(χ2=4.201,P<0.039)。结论:深部热疗联合同步放化疗是治疗中晚期宫颈癌、特别是巨块型宫颈癌的一种安全有效的方法,具有临床推广价值。

Objective： To evaluate the safety and efficacy of microwave hyperthermia in the treatment for advanced bulky cervical carcinoma. Methods： All 100 cases of cervical cancer patients with IIb- IIIbstage,tumor diameter greater than 4cm were treated by radiotherapy and chemotherapy,and were divided into control group and experimental group. Radiotherapy in control group： 6MV accelerator IMRT treatment ＋ 192 iridium in high dose rate intracavitary irradiation,concurrent cisplatin 40 mg / m2 intravenous,once a week,and external irradiation synchronization terminates.In the experimental group,the temperature was（ 40 ± 1） ℃,60 points / second,2 times / week. 1 month after the end of treatment to review the relevant examination. Results： In the experimental group,92%（ 46 /50） of CR was achieved,and the control group was only 78%（ 39 /50）. The tumor shrinkage rate was significantly higher than that in the control group（ P〈 0. 039）. Conclusion： Deep hyperthermia combined with radiotherapy and chemotherapy is a safe and effective method for the treatment of advanced cervical cancer,especially the giant cervical carcinoma.