三维腔内后装放疗治疗中晚期子宫颈癌的效果及安全性

Efficacy and safety of three-dimensional intraluminal post-loading radiotherapy in treatment of intermediate and advanced cervical cancer

目的探讨192Ir三维腔内后装放疗治疗局部中晚期子宫颈癌患者的效果及不良反应。方法回顾性分析2018年2月至2021年1月山西省肿瘤医院收治的100例接受放疗的中晚期子宫颈癌患者临床资料,其中50例接受192Ir三维腔内后装放疗的患者为三维组,50例接受192Ir二维腔内后装放疗的患者为二维组。比较两组治疗效果及不良反应。结果三维组客观缓解率高于二维组[98%(49/50)比84%(42/50)],差异有统计学意义(χ^(2)=4.40,P=0.036)。三维组急性放射性膀胱炎总发生率低于二维组[60%(30/50)比88%(44/50)],差异有统计学意义(χ^(2)=10.19,P=0.003);三维组1级急性放射性膀胱炎发生率低于二维组[26%(13/50)比48%(24/50)],差异有统计学意义(χ^(2)=5.19,P=0.038)。三维组急性放射性肠炎总发生率低于二维组[68%(34/50)比92%(46/50)],差异有统计学意义(χ^(2)=9.00,P=0.005);三维组2、3级急性放射性肠炎发生率均低于二维组[28%(14/50)比50%(25/50),4%(2/50)比20%(10/50)],差异均有统计学意义(χ^(2)=5.09,P=0.040;χ^(2)=6.06,P=0.028)。三维组慢性放射性肠炎总发生率低于二维组[28%(14/50)比54%(27/50)],差异有统计学意义(χ^(2)=6.99,P=0.014)。结论中晚期子宫颈癌患者192Ir三维腔内后装放疗较二维腔内后装放疗疗效好,急慢性放射性肠炎及放射性膀胱炎的发生率低。

Objective To investigate the clinical efficacy and adverse reactions of 192Ir 3-dimensional intraluminal post-loading radiotherapy in treatment of locally middle and advanced cervical cancer.Methods The clinical data of 100 middle and advanced cervical cancer patients in Shanxi Province Cancer Hospital from February 2018 to January 2021 were retrospectively analyzed,including 50 patients undergoing 192Ir 3-dimensional intraluminal post-loading radiotherapy(the 3D group)and 50 patients undergoing 192Ir 2-dimensional intraluminal post-loading radiotherapy(the 2D group).The therapeutic efficacy and adverse reactions of both groups were compared.Results The objective response rate of the 3D group was higher than that of the 2D group,and the difference was statistically significant[98%(49/50)vs.84%(42/50),χ^(2)=4.40,P=0.036].The overall incidence of acute radioactive cystitis in the 3D group was lower than that in the 2D group,and the difference was statistically significant[60%(30/50)vs.88%(44/50),χ^(2)=10.19,P=0.003].The incidence of grade 1 acute radiation cystitis in the 3D group was lower than that in the 2D group,and the difference was statistically significant[26%(13/50)vs.48%(24/50),χ^(2)=5.19,P=0.038].The overall incidence of acute radiation enteritis in the 3D group was lower than that in the 2D group,and the difference was statistically significant[68%(34/50)vs.92%(46/50),χ^(2)=9.00,P=0.005];the incidence of grade 2 and 3 acute radiation enteritis in the 3D group was lower than that in the 2D group,and the differences were statistically significant[28%(14/50)vs.50%(25/50);4%(2/50)vs.20%(10/50),χ^(2)=5.09,P=0.040;χ^(2)=6.06,P=0.028].The overall incidence of chronic radiation enteritis in the 3D group was lower than that in the 2D group,and the difference was statistically significant[28%(14/50)vs.54%(27/50),χ^(2)=6.99,P=0.014].Conclusions Compared with 2-dimensional intraluminal post-loading radiotherapy,3-dimensional intraluminal post-loading radiotherapy improves the efficacy of patients with intermediate and advanced cervical cancer,reduces the occurrence of acute and chronic radiation enteritis and radiation cystitis,reduces the adverse reactions of patients.