三维后装插植放疗治疗阴道残端复发肿瘤

Three-dimensional Interstitial Brachytherapy for Recurrent Tumors of Vaginal Stump

目的探讨三维后装插植放疗治疗阴道残端复发肿瘤情况。方法选取2017年1月至2018年1月我院宫颈癌手术后1年阴道残端复发肿瘤的10例作为研究对象,所有患者均经病理证实为阴道残端复发肿瘤,体外放疗结束后,所有患者采用三维后装插植放射治疗,观察靶区(CTV)剂量以及累及器官受量、不良反应(局部出血、感染、下腹痛)。结果后装插植包裹靶区(GTV)剂量V90为(6.08±1.27)Gy,GTV剂量V95为(6.02±1.31)Gy,符合计划治疗要求,具有高度靶区适形度;三维后装插植放疗在膀胱、直肠、乙状结肠1cm^3、2 cm^3、3 cm^3不同体积中插植放疗剂量无统计学差异(P>0.05);10例阴道残端复发肿瘤患者经三维后插植放疗治疗后3个月后有1例患者出现中度下腹痛,采取止痛、消炎后疼痛改善,其余患者未见局部出血、感染及下腹痛等不良反应;治疗6个月后未见不良反应。结论三维后装插值放疗治疗不良反应较少,但远期效果需长期观察。

Objective To investigate the effect of three-dimensional interstitial brachytherapy for recurrent tumors of vaginal stump. Methods Ten patients with recurrent tumors of vaginal stump confirmed by pathology after cervical cancer surgery in our hospital from January 2017 to January 2018 were selected as subjects. After the end of external beam radiotherapy, all patients were treated with three-dimensional interstitial brachytherapy, then the clinical tumor volume (CTV) dose and the involvement of organs, adverse reactions (local bleeding, infection, lower abdominal pain) were observed. Results The Gross Tumor Volume (GTV) dose V90 of interstitial brachytherapy was (6.08±1.27) Gy, and the GTV dose V95 was (6.02±1.31) Gy, which met the scheduled treatment requirements and had a high target conformity. There was no significant difference in the dose of interstitial brachytherapy between the bladder, rectum and sigmoid colon in different volumes of 1cm3, 2cm3 and 3cm3 forthree-dimensional interstitial brachytherapy(P>0.05). After treating with three-dimensional interstitial brachytherapy for 3 months, one patient developed moderate abdominal pain, which was improved after pain relief and anti-inflammatory. Other patients had no adverse reactions such as local bleeding, infection and lower abdominal pain. No adverse reactions were observed after 6 months of treatment. Conclusion Three-dimensional interstitial brachytherapy has fewer adverse reactions, but long-term effects require long-term observation.