宫颈残端插植配合体外放疗在宫颈残端癌中的应用

Application of Cervical Stump Implantation Combined with External Radiotherapy in the Cervical Stump Carcinoma

目的探讨宫颈残端插植近距离后装放疗技术在宫颈残端癌治疗中的作用。方法 15例宫颈残端癌患者给予体外调强放疗后,经阴道进行宫颈残端施源器插植术,术后经CT扫描定位并确认插植位置合格后,进行靶区勾画、剂量优化,用^(192)Ir近距离治疗机治疗,并观察治疗的疗效及并发症。结果全组15例患者中,CR 14例,PR 1例,中位生存时间为23个月,其中2例因远处转移死亡。随访期间出现近期并发症5例(1例为1级膀胱反应,4例为1级直肠反应),出现远期直肠反应2例,未发现膀胱远期并发症。结论宫颈残端插植近距离后装放疗配合体外调强放疗治疗宫颈残端癌疗效良好、安全可行。

Objective To investigate the role of brachytherapy of cervical stump implantation in the treatment of cervical stump carcinoma.Methods Fifteen patients with cervical stump carcinoma were treated with in vitro intensity modulation radiotherapy.The cervical stump applicator was implanted through vagina,and after CT scanning to confirm the qualification of implantation location,the target area was delineated,the dose was optimized,and were treated with the192Ir brachytherapy machine.The curative effect and complications were observed.Results Of the cases of cervical stump carcinoma,14cases of CR and1case of PR were reviewed.The median survival time was23months,and2cases of them died of distant metastasis.During the follow-up period,there were5cases of short term complications(1case of grade1bladder reaction,4cases of grade1rectal reaction),2cases of long term rectal reaction,and no long-term complications of bladder was observed.Conclusion Intensity-modulated radiotherapy in vitro combined with transvaginal brachytherapy is safe and feasible for cervical stump carcinoma.