超分割三维后装治疗在中晚期宫颈癌的临床应用研究

The clinical application of hyperfractionation three dimensional brachytherapy in advanced cervical cancer

目的比较中晚期宫颈癌超分割三维后装治疗与常规三维后装治疗的近期疗效及并发症。方法选取2014年8月-2015年8月接受三维后装治疗的ⅡB、ⅢB期的宫颈鳞癌患者(90例),分为研究组(32例)和对照组(58例),研究组进行超分割三维后装放疗,对照组进行常规三维后装放疗,研究超分割三维后装治疗的近期疗效及近期并发症,并与常规三维后装治疗进行对比分析。结果研究组患者的有效率为93.5%,对照组患者的有效率为92.9%,2种方法的近期疗效相当,差异无统计学意义(P=0.667);研究组放射性直肠炎的发生率为3.2%,对照组放射性直肠炎的发生率为23.2%,研究组放射性直肠炎的发生率明显低于对照组,差异有统计学意义(P=0.015);研究组放射性膀胱炎的发生率为6.5%,对照组放射性膀胱炎的发生率为12.5%,差异无统计学意义(P=0.481)。结论 2种治疗方法的近期疗效相近,但与常规三维后装相比,超分割三维后装治疗可以减少放射性直肠炎发生率,在治疗过程中能更好地保护直肠。

Objective To compare the recent efficacy and complications of the brachytherapy of hyperfractionation three-dimensional and conventional three dimensional brachytherapy in advanced cervical carcinoma.Methods Retrospective analysis was performed of 90 cases of cervical squamous carcinoma of the IIB and IIIB stage after three dimensional brachytherapy from August 2014 to August 2015 were divided into study group and control group,with each having 32 cases and 58 cases respectively.The study group was further sub-divided into three groups,and the patients in the control group were treated with three dimensional brachytherapy.Analyzed werethe short-term curative effect and recent complications after the brachytherapy of super segmented three-dimensional,and the routine three dimensional brachytherapy was compared.Results The effective rate of the study group（CR＋PR）was 93.5%,the rate of the control group（CR＋PR）was 92.9%,in terms of two methods of curative effect,there was no significant difference（P =0.667）;the study group radiation proctitis incidence rate was 3.2%,control group was 23.2%,The study group of radiation proctitis was significantly lower than that in control group（P =0.015）;the study group of radiocystitis incidence rate was 6.5%,the control group was 12.5%,there was no significant difference（P =0.481）.Conclusion There were no significant differences between the two treatments in the near future.But compared with conventional 3Dbrachytherapy,hyperfractionated three-dimensional brachytherapy was shown to be able to reduce the incidence of radiation proctitis,wherein which can better protect the rectum.