宫颈癌盆腔淋巴结转移调强放射治疗的疗效分析

目的 探讨调强放射治疗(IMRT)对宫颈癌盆腔淋巴结转移患者的临床疗效.方法 回顾性分析94例宫颈癌患者的临床资料,将47例行IMRT方法治疗的患者作为IMRT组,将47例行普通放疗方法治疗的患者作为普通放疗组.分析比较两组患者治疗3个月后的近期疗效、急性不良反应和3年的生存情况.结果 治疗3个月后,IMRT组盆腔淋巴结完全消失和缩小消退的比例均高于普通放疗组(P﹤0.05).IMRT组3年死亡29例,累积生存率为38.3%,普通放疗组3年死亡34例,累积生存率为27.7%,IMRT组和普通放疗组的中位生存时间分别为29(23~35)个月和13(7~20)个月,IMRT组中位生存时间长于普通放疗组(P﹤0.05).IMRT组消化系统和骨髓抑制等急性不良反应均较普通放疗组明显减少,差异有统计学意义(P﹤0.01),且IMRT组均未出现3级不良反应.结论 I MRT不仅可以提高瘤体组织的放射剂量,还可以提高治疗的疗效,减少急性不良反应的发生,延长患者治疗后3年的中位生存时间.

The efficacy of intensity-modulated radiation therapy in patients with cervical cancer and pelvic lymph node metastases

Objective To investigate the clinical effect of intensity-modulated radiation therapy (IMRT) in patients with cervical cancer and pelvic lymph node metastases. Method The clinical data of 94 patients with cervical cancer were retrospectively analyzed, in which 47 patients were treated with IMRT (IMRT group), and another 47 patients were treated with conventional radiotherapy (conventional radiotherapy group). The 3-month short-term efficacy, acute adverse reactions and 3-year survival in the two groups were compared and analyzed. Result After 3 months of treatment, the proportion of disappeared or subsided pelvic lymph nodes in IMRT group was higher than that in the conventional radio-therapy group (P<0.05). There were 29 cases of death in the IMRT group in 3 years, with a cumulative survival rate of 38.3%, and that were 34 cases and 27.7%in the conventional radiotherapy group, besides, the median survival time was 29 (23-35) months in IMRT group, which was significantly longer than that in the conventional radiotherapy group at 13 (7-20) months (P<0.05). In the IMRT group, digestive system adverse reactions and bone marrow suppression were signif-icantly reduced (P<0.01), and no adverse reactions of grade 3 occurred in the IMRT group. Conclusion IMRT can not only increase the radiation dose of tumor tissues, but also improve the curative effect, and thus reduces the incidence of acute adverse reactions and prolongs the 3-year median survival time after treatment.