3D打印模板插植后装放疗联合深部热疗对盆腔复发性宫颈癌的疗效分析

Efficacy of three-dimensional-printed template interstitial brachytherapy combined with deep hyperthermia in the treatment of pelvic recurrent cervical cancer

目的:探讨3D打印模板插植后装放疗(brachytherapy,BT)联合深部热疗(hyperthermia,HT)对盆腔复发性宫颈癌的近期疗效。方法:选取2017年1月至2021年3月河北省沧州中西医结合医院收治的复发性宫颈癌患者73例临床病理资料,其中单独行3D打印模板插植后装放疗39例为对照组、联合深部热疗34例为研究组。后装放疗1次/周,4~6次,深部热疗2次/周,温度控制在41℃左右,时间为40~60 min。比较两组患者3个月的近期疗效和不良反应发生率。结果:39例对照组中完全缓解(complete response,CR)8例,部分缓解(partial response,PR)14例,疾病稳定(stable disease,SD)11例;34例研究组中CR为18例,PR为10例,SD为4例。对照组和研究组的客观缓解率(objective response rate,ORR)分别为56.4%(22/39)和82.4%(28/34),研究组的ORR优于对照组,差异具有统计学意义(χ^(2)=5.66,P=0.017)。对照组和研究组的疾病控制率(disease control rate,DCR)分别为84.6%(33/39)和94.1%(32/34),研究组的DCR优于对照组,但差异无统计学意义(χ^(2)=0.85,P=0.360)。研究组与对照组相比,肠道和尿道不良反应更少,差异具有统计学意义(P=0.023和P=0.003)。结论:3D打印模板插植后装放疗联合深部热疗对复发性宫颈癌有较好的近期疗效,同时未增加不良反应。

Objective:To investigate the application of three-dimensional(3D)-printed template interstitial brachytherapy combined with deep hyperthermia(HT)in treating pelvic recurrent cervical cancer.Methods:This study enrolled 73 patients with pelvic recurrent cervical cancer admitted to Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from January 2017 to March 2021.All patients received 3D-printed template interstitial brachytherapy once weekly in 4–6 fractions.Thirty-nine patients in the control group were treated with only brachytherapy,and 34 patients in the study group were treated with brachytherapy combined with deep HT.Deep HT was prescribed twice weekly,and the temperature was controlled at approximately 41℃for 40–60 min.The local control rate at 3 months and adverse reactions were compared between the two groups.Results::In the control group of 39 patients,eight had complete response(CR),14 had partial response(PR),11 had stable disease(SD),and 6 had progressive disease(PD).In contrast,in the study group of 34 patients,18 patients had CR,10 had PR,4 had SD,and 2 had PD.The objective response rates of the control and study groups were 56.4%(22/39)and 82.4%(28/34),respectively,with a statistically significant difference(χ^(2)=5.66,P=0.017).The disease control rates(DCRs)of the control and study groups were 84.6%(33/39)and 94.1%(32/34),respectively.The DCR of the study group was better than that of the control group,but there was no statistical significance(χ^(2)=0.85,P=0.360).The adverse reactions in the rectum and urethra in the study group were less compared with those in the control group(P=0.023,P=0.003).Conclusions:3Dprinted template interstitial brachytherapy combined with deep hyperthermia showed good short-term efficacy for recurrent cervical cancer and did not increase adverse reactions.