三维适形放疗、调强放疗和容积调强放疗在宫颈癌术后患者中的应用

目的比较三维适形放疗(3D-CRT)、调强放疗(IMRT) 和容积调强放疗（VMAT)技术在术后伴有中、高危因素的早期宫颈癌患者中的疗效及不良反应，探讨术后伴有中、高危因素的早期宫颈癌患者术后辅助放疗的最佳治疗模式。方法接受术后辅助放疗的120例具有中、高危因素的早期宫颈癌患者，按照随机数字表法平均分成3组，其中3D-CRT、IMRT及VMAT各40例，比较观察3种治疗方式的疗效及不良反应。结果3组1、2、3年生存率比较差异无统计学意义(P>0.05)。在不良反应方面，使用IMRT和VMAT技术患者的不良反应发生率相似(P>0.05)；急性胃肠道反应和泌尿道反应发生率，IMRT和VMAT技术优于3D-CRT技术（P<0.05）；放射性肠炎及膀胱炎的发生率，3D-CRT、IMRT和VMAT技术未发现差异(P>0.05)。结论具有中、高危因素的早期宫颈癌术后患者，采用IMRT、VMAT和3D-CRT技术放疗，其短期生存率相似，IMRT和VMAT不良反应的发生率低于3D-CRT；IMRT和VMAT不良反应发生率无明显差异。

The efficacies rates and side effects of different radiotherapy techniques for postoperative patients with early cervical cancer

ObjectiveTo study the curative effects and adverse reactions of volumetric modulated arc therapy (VMAT), intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3D-CRT) for early stage postoperative cervical cancer with medium-high risk factors, in order to investigate the best mode of postoperative adjuvant radiotherapy for early stage postoperative cervical cancer with medium-high risk factors. Methods To analyze the efficacies and adverse reactions of the 120 early stage cervical cancer patients with medium-high risk factors and postoperative radiotherapy in our hospital. They were evenly divided into 3D-CRT group, IMRT group and VMAT group, according to the random number table method. ResultsThere was no statistically significant difference in 1-year, 2-year, or 3-year survival rate among the 3 groups (P>0.05). The incidence of patients with IMRT and VMAT technology in terms of adverse reactions was similar (P>0.05). IMRT and VMAT in terms of acute gastrointestinal and urinary reactions were superior to 3D-CRT (P<0.05). In terms of the incidence of radiation proctitis and cystitis, no significant difference was found among 3D-CRT, IMRT and VMAT (P>0.05). ConclusionOur results suggest that the early stage postoperative cervical cancer with medium-high risk factors receiving adjuvant radiotherapy IMRT, VMAT or 3D-CRT have similar short-term survival rate; but IMRT and VMAT have lower toxicity compared with 3D-CRT. There is no significant difference in the incidence of adverse reactions between IMRT and VMAT.