早期宫颈癌手术后IMRT和3D-CRT治疗的对比分析

Comparative Analysis of IMRT and 3D-CRT in the Treatment of Early Cervical Cancer after Operation

目的探讨早期宫颈癌手术后调强放疗(intensive radiotherapy,IMRT)和三维适形放疗(three-dimensional conformal radiotherapy,3D-CRT)治疗的效果。方法选取110例早期宫颈癌手术患者,按受试顺序平均分成2组。对照组55例术后采用3D-CRT治疗,研究组55例术后IMRT治疗,观察2组在疗效等指标上变化情况。结果研究组治疗后在血小板下降、血红蛋白下降、白细胞下降、消化系统损伤、泌尿系统损伤、放射性直肠炎及放射性膀胱炎等Ⅲ级发生率上显著低于对照组(P<0.05);2组总有效率比较差异无统计学意义(P>0.05)。对照组局部复发率16.36%、远处转移率7.27%,研究组局部复发率7.27%、远处转移率3.64%,2组比较差异显著(P<0.05)。2组治疗前生理维度、社会家庭维度、情感维度、功能维度、宫颈癌特意维度评分比较差异均不显著(P>0.05),治疗后均较治疗前显著提高(P<0.05),且研究组显著优于对照组(P<0.05)。结论早期宫颈癌术后IMRT和3D-CRT疗效相当,但IMRT不良反应相对较低,生活质量更高,复发率更低。

Objective To investigate the surgical early cervical cancer after intensity-modulated radiotherapy(Intensive radiotherapy,IMRT)and three dimensional conformal radiotherapy(Three-dimensional conformal radiotherapy,3D-CRT)after the treatment of curative effect.Methods 110 cases of early cervical cancer patients,according to the subjects were divided into 2 groups,55 cases in the control group were treated with 3D-CRT,55 cases of the study group were treated with IMRT treatment,observation of different methods in the treatment of changes were conducted.Results The study group after the treatment in the decrease of platelet,hemoglobin decreased,the decrease of white blood cells,digestive system injury,urinary system damage,radiation proctitis and cystitis 0 level incidence was significantly higher than the control group,and the incidence of grade Ⅲ was significantly lower than the control group,there was significant difference between the 2 groups(P<0.05);the 2 group had no significant difference(P>0.05);the control group the recurrence rate was 16.36%,the distant metastasis rate was 7.27%,the study group the recurrence rate was 7.27%,the distant metastasis rate was 3.64%.There was significant difference between two groups(P<0.05);the two groups before treatment,physiological dimension,family dimension,emotional dimension,social function dimension specifically,cervical cancer score no significant difference was found(P>0.05),after treatment than before treatment significantly increased(P<0.05),the study group was significantly better than the control group(P<0.05).Conclusion The effect of IMRT and 3D-CRT is similar in the early stage of cervical cancer,but the adverse reactions of IMRT are relatively low,the quality of life is higher,and the recurrence rate is lower.