同步推量调强放疗技术治疗局部中晚期宫颈癌的应用价值

Application value and cause analysis of simultaneous pulse intensity modulated radiotherapy in the treatment of locally advanced cervical cancer

目的 探讨同步推量调强放疗技术在局部中晚期宫颈癌的应用价值。方法 回顾性选取2010年1月至2015年12月期间广西医科大学第四附属医院收治的局部晚期宫颈癌患者160例作为观察对象,按照住院尾号单双号情况将观察对象分为SMART组(n=87)和IMRT组(n=73),其中SMART组采用同步推量调强放疗技术治疗,IMRT组采用调强放疗技术治疗。对比分析两组治疗近期、远期疗效及放射性肠损伤及膀胱损伤情况。结果 SMART组治疗结束后3个月疗效评价的总有效率(91.95%)高于IMRT组(80.82%),差异具有统计学意义( P <0.05);SMART组急慢性放射性肠损伤及膀胱损伤的发生率均低于IMRT组,差异具有统计学意义( P <0.05);SMART组治疗后1年及2年生存率均高于IMRT组,但差异无统计学意义( P >0.05),SMART组治疗后1年及2年的疾病无进展生存率均高于IMRT组,差异有统计学意义( P <0.05)。结论 与调强放疗技术相比,同步推量调强放疗技术提高远期患者生存率方面优势不明显,但可提高局部中晚期宫颈癌治疗近期疗效,降低急慢性放射性肠损伤及膀胱损伤发生率,提高远期疾病无进展生存率,从而改善患者的生活质量,值得临床推广应用。

Objective To explore the application value and cause of synchronous incremental intensity modulated radiotherapy in locally advanced cervical cancer. Methods 160 patients with locally advanced cervical cancer admitted to our hospital from January 2010 to December 2015 were selected as the observation objects. According to the condition of single or double numbers of the tail number, the observation objects were divided into SMART group (n=87) and IMRT group (n=73). Among them, SMART group was treated with synchronous push intensity modulated radiation therapy. IMRT group was treated with intensity modulated radiation therapy. The short-term and long-term therapeutic effects, radiation intestinal injury and bladder injury of the two groups were compared and analyzed. Results The total effective rate of three months after treatment in SMART group was 91.95% higher than that in IMRT group (80.82%, P <0.05). The incidence of acute and chronic radiation-induced intestinal injury and bladder injury in SMART group was lower than that in IMRT group ( P <0.05). The 1-year and 2-year survival rates in SMART group were higher than those in IMRT group ( P <0.05). There was no significant difference between IMRT group and SMART group ( P >0.05). The 1-year and 2-year disease-free survival rate of SMART group was higher than that of IMRT group ( P <0.05). Conclusion Compared with IMRT, synchronous push-intensity modulated radiation therapy has no obvious advantages in improving long-term survival rate, reducing the incidence of acute and chronic radiation intestinal injury and bladder injury, and improving the progression-free survival rate of long-term diseases, so as to improve the quality of life of patients, which is worthy of clinical application.