宫颈癌患者同步放化疗后三维适形放疗与调强放疗的血液毒性比较

Comparison of Hematologic Toxicity of Three-dimensional Conformal Radiotherapy and Intensity Modulated Radiation Therapyin for Cervical Cancer after Chemoradiotherapy

目的比较宫颈癌患者同步放化疗后三维适形放疗与调强放疗的血液毒性(HT)。方法将符合纳入标准的180例宫颈癌患者分为2组:3DCRT组(89例)和IMRT组(91例)。检测化疗期间及放疗2年内血红蛋白、白细胞、中性粒细胞和血小板计数的最低水平。结果 2级或以上急性贫血、白细胞减少、粒细胞减少症和血小板减少症3DCRT组分别为2%、42%、11%,0;IMRT组分别为26%,53%,24%,和4%。2级或以上慢性贫血、白细胞减少、粒细胞减少症和血小板减少症在3DCRT组分别为12%、12%、6%和12%;IMRT组分别为0、9%、4%、和0。LS-V30,40;IL-V10,20,30,40;LP-V10,20,40;P-V10,20,30,40;WP-V10,20,30,40;与3DCRT组相比,IMRT组显著减少。结论与三维适形放疗,IMRT可减少照射的骨髓体积,然而在急性和慢性HT方面,两种技术比较无差异。

Objective To compare the hematologic toxicity ( HT ) of three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy ( IMRT) for cervical cancer after chemoradiotherapy .Methods 180 cervical cancer patients were divided into 2 groups:3DCRT group (89 cases) and IMRT group (91 cases).Hemoglobin,white blood cells,neutrophil and platelet counts lowest levels within during chemotherapy and 2 years radiotherapy were detected .Results Grade 2 or greater acute anemia,leukopenia,neutropenia,thrombocytopenia in 3DCRT group were 2%,42%,11%,and 0;and those of the IMRT group were 26%,53%,24%,and 4%.Grade 2 or greater chronic anemia ,leukopenia ,neutropenia ,and throm-bocytopeniain 3DCRT group were 12%,12%,6%,and 12%;and those of the IMRT group were 0,9%,4%,and 0.LS-V30,40;IL-V10,20,30,40;LP-V10,20,40;P-V10,20,30,40,and WP-V10,20,30,40,IMRT group significantly reduced compared with 3DCRT group.Conclusion Compared with 3DCRT,IMRT can reduce exposed bone marrow volume ,while there is no difference between the two techniques in terms acute and chronic HT .