巨块型宫颈癌术前放疗20例临床观察

Clinical Study of 20 Cases of Bulky Cervical Cancer Treated with Preoperation Vaginal Intracavitary Irradiation

[目的]探讨较早期巨块型宫颈癌术前适当剂量阴道腔内放疗的意义。[方法]经宫颈活检病理检查确诊,宫颈肿块4cm^7cm的Ⅰb2期和Ⅱa期宫颈癌患者20例,采用后装治疗机阴道腔内放射源为192铱(192Ir),A点剂量为2100cGy^2400cGy,分3~4次照射,每次间隔3~4天,放疗前、放疗后和手术前经阴道窥器肉眼观察测量和B超探查综合观察肿块变化情况。[结果]宫颈肿块均有不同程度的缩小,有效率90%,放疗结束后7~10天19例行宫颈癌根治术。手术标本病理检查4例已无癌细胞,2例散在退变癌细胞,其余同术前。[结论]较早期巨块型宫颈癌行宫颈癌根治术前适当剂量腔内放疗,使肿瘤缩小,有利于手术进行,不增加手术副损伤和并发症。

To evalate the therapeutic efficacy of preop er ative vaginal intracavitary irradiation for ear-ly stage bulky cervical carcino ma.Twenty cases of stageⅠb2andⅡa cervical carcinoma with tumor diamet er of4cm^7cm were treated.Before treatment,all cases had biopsy proven.Patients were treated by after-loading vaginal intracativitary brachytherapy with 192 Ir source.Total doses of radiation at Point A were2100cGy～2400cGy in3～4tim es every3～4days.The tumor size were evaluated by colposcopy and sonogra-phy be fore and after radiation,and preoperation.Tumor volume shrinked in diff erent degree after irra-diation.Therapeutic response rate was90%.Nineteen patie nts underwent radical hysterectomy7～10days af-ter irradiation.No cancer cell w as found in operative speciments in four cases degeneration in two patients.The tumor size was not changed in the remains.[Conclusions]Preoperative vaginal intr acavitary irradiation in proper doses before radical hysterectomy may reduce the tumor volume and benefit to operation.Adverse op-erative events and complicati ons are not increased.