延伸野IMRT对宫颈癌预后研究进展

Prognostic analysis of extended field intensity-modulated radiation therapy for cervical cancer

近几十年精确放疗技术发展迅速，IMRT在妇科恶性肿瘤中的应用也逐渐增加。研究表明在晚期宫颈癌患者中有很高的隐匿性腹主动脉旁淋巴结转移的发生率，而盆腔和腹主动脉旁淋巴结状态是宫颈癌患者重要预后影响因素。既往预防性延伸野常规放疗存在严重胃肠道副反应，联合同步化疗也存在争议。现有研究对于转移性盆腔及腹主动脉旁淋巴结的最佳放疗剂量也未达成共识。本文主要分析预防性延伸野IMRT联合同步化疗对宫颈癌患者预后影响和淋巴结阳性区域剂量效应关系。

In recent decades, accurate radiotherapy has developed rapidly, and the application of intensity-modulated radiation therapy （IMRT） in gynecologic malignancies has increased gradually in the past ten years. Many studies have shown a high rate of occult abdominal aortic lymph node metastasis in patients with advanced cervical cancer, while pelvic and abdominal aortic lymph node status are important prognostic factors it1 cervical cancer patients. Conventional prophylactic extended field radiotherapy has the characteristics of severe gastrointestinal side effects, and synchronic chemotherapy is also controversial. The optimal dose of radiation therapy for metastatic pelvic and abdominal aortic lymph nodes is still controversial. This paper mainly analyzed the effect of prophylactic extended conformal radiotherapy with concurrent chemotherapy on the prognosis of cervical cancer and the dose-effect relationship of lymph node positive region.