以三维适形放疗推量的宫颈癌治疗的初步研究

目的:研究宫颈癌去除后装腔内治疗以三维适形放疗推量的可行性、治疗效果及对直肠膀胱并发症发生的影响。方法:60例宫颈癌,随机分组,去除后装组(观察组)26例,外照射结合后装组(对照组)34例。大野照射40Gy/20次后,观察组缩野三维适形照射,总剂量65～70Gy左右,不超过75Gy;对照组中央铅挡盆腔照射给宫旁补量,使外照射B点剂量达45～50Gy;后装治疗补充A点剂量30Gy左右(4～7.5Gy/次,1～2次/周)。结果:两组近期疗效确切,观察组急性消化道发生率低,泌尿系反应发生率相似,观察组反应相对较轻。结论:宫颈癌去后装三维适形放疗可以明显减少急性放射性直肠炎、膀胱炎的发生,近期疗效确切。

Clinical study of cervical cancer treated with more dose by fhe three dimensional conformal radiation(3-DCRT) without afterloading irradiation

Objective:To evaluate the feasibility and the therapeutic effect which the cervical cancers obtained more dose by the dimensional conformal radiation(3-DCRT) without afterloading irradiation,and complications of rectum or bladder.Methods:Sixty cases of cervical cancers were randomly allocated into two groups.The test group(26 cases,3-DCRT),the control group(34 cases,external radiation and afterloading irradiation).After received 40Gy/20 fractions of external radiation to the whole pelvic,Patients in the test group were reduced radiation fields by 3-DCRT,the total dose 65~70Gy in general,no more than 75Gy,in the control group received 45~50Gy external radiation to the parametrrium,and point A received 30Gy by afterload irradiation(4~7.5Gy per fraction,1~2 fractions per week).Results:The effect of the 2 groups were affirmative,the rates of acute complication for the rectum were significantly lower in the test group than in the control group,the rates of complication for the bladder were simillar,and the response of the test group was slightly.Conclusion:The 3-DCRT without afterloading irradiation of cervical cancer may decrease the complication for rectum or bladder and the short-term effect is affirmative.