三维适形调强放疗治疗宫颈残端癌的临床观察

目的 探讨三维适形调强放疗联合近距离腔内照射治疗宫颈残端癌的有效性和安全性。方法 回顾性分析南京医科大学附属江苏省肿瘤医院1994年1月至2013年12月间收入院行放疗的41例宫颈残端癌患者临床资料，其中2012年后收治的23例患者行三维适形调强放疗联合近距离腔内照射（三维适形组），2012年前收治的18例患者行体外常规放疗联合近距离腔内照射（常规放疗组），评价两组患者的近期疗效及毒副反应情况。结果 常规放疗组获CR 8例，PR 6例，总有效率为77.8％，鳞癌抗原（SCC）下降率为（61.3±20.4）％；三维适形组CR 12例，PR 8例， 总有效率为87.0％， SCC下降率为（75.9±4.3）％；两组的SCC下降率差异具有统计学意义（P＜0.05）。常规放疗组患者出现近期并发症17例，其中1～2级直肠反应13例，1级膀胱反应4例；三维适形组出现近期并发症6例，均为1级直肠反应。结论 三维适形调强放疗联合近距离腔内照射可能是宫颈残端癌提高近期疗效、减少放疗并发症的有效治疗模式。

Clinical observation of the intensity modulated radiotherapy in cervical stump cancer

Objective To evaluate the efficacy and side effects of the intensity modulated radiotherapy in cervical stump cancer. Methods A retrospective study included 41 patients from January 1994 to December 2013 with cervical stump cancer was performed. Before 2012， 18 cases as control group were received conventional external beam radiotherapy and brachytherapy. Since 2012，23 cases as experimental group were treated with intensity modulated radiotherapy（IMRT） and brachytherapy. The efficacy and complications of two groups were evaluated. Results In the control group，there was 8 cases CR， 6 cases PR， and the response rate was 77.8％， and the decreasing rate of SCC was（61.3±20.4）％. In the experimental group， there was 12 cases CR， 8cases PR， and the response rate was 87.0％， and the decreasing rate of SCC was（75.9±4.3）％. There was 17 patients suffered toxicities including 13 grade 1-2 acute rectum reaction，4 grade 1 bladder reaction the control group， while in the experimental group， only 6 patients suffered grade 1 acute rectum reaction. Conclusion The IMRT and braehytherapy for the patients with cervical stump cancer have better effects and less complications.