组织间插植与阴道盒近距离放射治疗宫颈癌的疗效对比

Comparison Of Efficacies Between Interstitial Implant And Vaginal Cassette Brachytherapy For Cervical Carcinoma

目的 探讨组织间插植与阴道盒后装放射治疗宫颈癌的疗效。方法 80例大体积 ,外生肿瘤直径≥ 4.0cm的宫颈癌应用高剂量率近距离放射治疗 ,以消除局部肿瘤和止血。其中 ,40例菜花型宫颈癌患者接受组织间插植放疗 ,将其分为A、B组。A组 ( 2 0例 ) :术前插植放疗 +宫颈癌根治术 ;B组 ( 2 0例 ) :插植放疗 +常规放疗。另 40例接受了阴道盒放疗的宫颈癌患者被分为C、D组。C组 ( 18例 ) :阴道盒放疗 +宫颈癌根治术 ;D组 ( 2 2例 ) :阴道盒放疗 +常规放疗。比较A、C组的消除肿瘤疗效和B、D组的止血效果。结果 A、C组的完全缓解率 (CR )各为 90 %、11% ,2组比较有非常显著性差异 (P <0 .0 1)。B、D组的止血显效率各为 10 0 %、64 %。 2组比较有非常显著性差异 (P <0 .0 1)。结论 组织间插植放射治疗对消除宫颈巨大。

Objective To evaluate the efficacies between interstitial implant and vaginal cassette brachytherapy for cervical carcinoma.Methods 80 patients with huge and exophytic cervical carcinoma(diameter≥4.0 cm)received high-dose rate brachytherapy to shrink locoregional tumor and to stop bleeding.40 cases of cervical carcinoma who received interstitial implant irradiation were divided into group A and B:Group A(20 cases) received a preoperative interstitial implant irradiation and cervical cancer radical resection;Group B(20 cases) received both interstitial implant irradiation and routine irradiation.Another 40 patients who received vaginal cassette irradiation were divided into group C and D:Group C(18 cases) received a preoperative vaginal cassette irradiation and cervical cancer radical resection;Group D(22 cases)received vaginal cassette irradiation and routine irradiation.The effect of shrinking locoregional tumor between group A and group C and the effect of stopping bleeding between between group B and group D were compared.Results 90% cases in group A and 11% cases in group C achieved complete remission(CR),showing a significant difference(P<0.01).The effective rate of stopping bleeding in group B and D was 100% and 64%,respectively,showing a significant difference(P<0.01).Conclusion Interstitial implant irradiation is an effective method for shrinking the huge exogenous cervical tumor and stopping bleeding locally.