SMART与IMRT治疗晚期宫颈癌的近期临床观察

Early clinical observation of SMART and IMRT in the treatment of advanced cervical cancer

目的比较同步推量调强放射治疗(SMART)与常规调强放疗(IMRT)治疗晚期宫颈癌的早期临床疗效和毒性反应。方法选取68例晚期宫颈癌患者为研究对象,根据治疗方案不同分为观察组(n=28)和对照组(n=40),观察组予以SMART治疗,对照组予以IMRT治疗。两组计划靶区(PTV)46.8 Gy/26F,1.8 Gy/F,SMART计划肿瘤同步推量靶区(GTV-SIB)62.4 Gy/26F,2.4 Gy/F。两组均给予腔内后装治疗和同步化疗,比较两组近期疗效和毒性反应。结果放疗结束后1个月复查,观察组的完全缓解(CR)率(85.71%)高于对照组(70.00%),疾病稳定(SD)率(0)低于对照组(10.00%)(P均<0.05);两组近期不良反应发生率差异无统计学意义(P均>0.05)。结论与IMRT相比,SMART治疗晚期宫颈癌近期临床效果显著,毒性反应相当。

Objective To compare the early clinical efficacy and toxicity of synchronous push intensity modulated radiation therapy （SMART） and conventional intensity modulated radiation therapy （IMRT） in the treatment of advanced cervical cancer. Methods 68 patients with advanced cervical cancer were selected as the research objects, according to the way of radiotherapy they were divided into observation group （28 cases） and control group （40 cases）. The observation group were treated with SMART, and the control group were treated with IMRT. Planned target area （ PTV） was 46. 8 Gy/26F ,1.8 Gy/F, SMART plan tumor synchronous pushing target area （ GTV - SIB） was 62. 4 Gy/26F, 2.4 Gy/F. The two groups were treated with endovascular therapy and concurrent chemotherapy, and the short - term efficacy and toxicity of the two groups were compared. Results After the end of the 1 month, the CR rate of observation group was higher than that of control group, and the rate of SD was lower than that of control group （ P 〈0.05） . There was no significant difference in adverse reactions between the two groups （ all P 〉 0.05） . Conclusion Compared with IMRT, SMART treatment of advanced cervical cancer has better efficacy, and adverse reaction is similar.