Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Meth...Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total dose of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median dose of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%, 70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups. Compared to the two groups each other in toxic effects, except for the I-II grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new role for 3DCRT merits need further evaluation with large patient numbers and longer follows up.展开更多
目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按...目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按照施源器的不同分成2个组,每组36次,对靶区剂量、危及器官等进行比较。结果:在给予A点相同处方剂量的情况下,HR-CTV D90、D100在三管式腔内后装组与腔内结合组织间插植后装组中分别为(590.0±46.4)cGy、(471.2±66.2)cGy,(502.8±67.7)cGy、(335.9±46.0)cGy,P<0.05),膀胱、直肠、乙状结肠D2cc均相近(P=0.85、0.28、0.53)。结论:采用腔内结合插植后装治疗局部晚期宫颈癌比三管式腔内后装可获得更高的靶区剂量,但长期疗效及晚期反应仍需进一步研究。展开更多
文摘Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total dose of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median dose of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%, 70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups. Compared to the two groups each other in toxic effects, except for the I-II grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new role for 3DCRT merits need further evaluation with large patient numbers and longer follows up.
文摘目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按照施源器的不同分成2个组,每组36次,对靶区剂量、危及器官等进行比较。结果:在给予A点相同处方剂量的情况下,HR-CTV D90、D100在三管式腔内后装组与腔内结合组织间插植后装组中分别为(590.0±46.4)cGy、(471.2±66.2)cGy,(502.8±67.7)cGy、(335.9±46.0)cGy,P<0.05),膀胱、直肠、乙状结肠D2cc均相近(P=0.85、0.28、0.53)。结论:采用腔内结合插植后装治疗局部晚期宫颈癌比三管式腔内后装可获得更高的靶区剂量,但长期疗效及晚期反应仍需进一步研究。
