| 中晚期宫颈癌患者调强放疗与同步推量调强放疗预后比较 |
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| 引用本文： | 黄维,李英,龙强,鲁文力,姜庆丰,谭本旭,田丽娟,罗弋,肖英.中晚期宫颈癌患者调强放疗与同步推量调强放疗预后比较[J].国际放射医学核医学杂志,2016,40(6):429-434. |
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| 作者姓名： | 黄维 李英 龙强 鲁文力 姜庆丰 谭本旭 田丽娟 罗弋 肖英 |
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| 作者单位： | 400016, 重庆医科大学附属第一医院肿瘤科 |
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| 基金项目： | 重庆市卫生局医学科研计划重点项目(2013-1-009)，Medical Research Fundation of Chongqing Heath Bureau(2013-1-009) |
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| 摘 要： | 目的 探讨同步推量调强放疗（SIB-IMRT）技术治疗中晚期宫颈癌患者的不良反应、远期疗效及相关预后因素。 方法 回顾性分析2009年1月至2015年6月收治的277例中晚期未手术的宫颈癌患者，其中70例行IMRT，207例行SIB-IMRT。比较中晚期宫颈癌患者行IMRT与SIB-IMRT后的不良反应，并进行远期疗效及预后因素分析。采用Kaplan-Meier法计算生存率，Cox法行多因素预后分析。 结果 IMRT组与SIB-IMRT组的随访率均为100%。与IMRT相比，SIB-IMRT未增加患者直肠及膀胱的急性毒性反应（χ2=0.306和0.971，P均>0.05）和远期毒性反应（χ2=0.014和0.381，P均>0.05）。IMRT组及SIB-IMRT组患者1年总生存率（OS）分别为100%和99.5%，3年OS分别为75.0%和84.7%，差异无统计学意义（χ2=0.339和0.674，P均>0.05）。患者年龄和治疗前淋巴结状态是所有入组患者（χ2=7.971和15.938，P均 < 0.05）及SIB-IMRT组患者（χ2=7.503和10.048，P均 < 0.05）生存的预后影响因素。 结论 初步结果表明SIB-IMRT技术安全可行，且可以减少后装治疗次数，减轻患者后装治疗的不适及痛苦。对于中晚期宫颈癌患者，SIB-IMRT是一种可尝试的外照射技术。
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| 关 键 词： | 宫颈肿瘤 预后 调强放射治疗 同步推量调强放疗 |
| 收稿时间： | 2016-09-13 |
Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy:a comparative study of 277 patients with advanced cervical cancer |
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| Wei Huang,Ying Li,Qiang Long,Wenli Lu,Qingfeng Jiang,Benxu Tan,Lijuan Tian,Yi Luo,Ying Xiao,Wenji Fang.Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy:a comparative study of 277 patients with advanced cervical cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):429-434. |
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| Authors: | Wei Huang Ying Li Qiang Long Wenli Lu Qingfeng Jiang Benxu Tan Lijuan Tian Yi Luo Ying Xiao Wenji Fang |
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| Affiliation: | Department of Oncology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China |
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| Abstract: | Objective To explore the toxicity,long-term overall survival (OS),and prognostic factors in advanced cervical cancer treated with IMRT and simultaneous integrated boost-intensity modulated radiation therapy(SIB-IMRT).Methods A retrospective analysis was performed on 277 patients with advanced cervical cancer.These patients were admitted from January 2009 to June 2015.Among the 277 patients,70 patients received IMRT,and 207 patients received SIB-IMRT.Toxicities,survival rates,and prognostic factors were compared between the two groups.The Kaplan-Meier method was used to calculate the survival rates,and the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100％ in both the IMRT and SIB-IMRT groups.Compared with IMRT,SIB-IMRT showed no significant differences in acute proctitis and cystitis toxicities (x2=0.306,0.971,both P＞0.05),as well as in long-term toxicity (x2=0.014,0.381,both P＞0.05).The 1-year OS rates for the IMRT and SIB-IMRT groups were 100％ and 99.5％,respectively,and the 3-year OS rates were 75.0％ and 84.7％,correspondingly(x2=0.339,0.674,both P＞0.05).The age and status of the pretreatment lymph nodes were the prognostic factors for all patients(x2=7.971,15.938,both P＜0.05),including the SIB-IMRT group (x2=7.503,10.048,both P＜0.05) in terms of OS.Conclusion Results indicated that SIB-IMRT can feasibly treat advanced cervical cancer.SIB-IMRT is a promising alternative treatment for patients who are not fit for brachytherapy treatment;this method also helps to reduce treatment fractions.Hence,SIB-IMRT is a recommended external beam technology for cervical cancer treatment. |
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| Keywords: | Uterine cervical neoplasms Prognosis Intensity-modulated radiation therapy Simultaneous integrated boost-intensity modulated radiation therapy |
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