高剂量率近距离放射治疗原发性阴道癌51例效果观察

目的：评价高剂量率近距离放射治疗（放疗）原发性阴道癌的效果,并与传统腔内镭疗进行比较。方法：对1989年1月－1999年12月期间接受了高剂量率近距离放疗的原发性阴道癌患者51例的临床资料进行回顾性分析。按国际妇产科联盟（FIGO）临床分期标准进行分期,I期10例,Ⅱ期13例,Ⅲ期23例,Ⅳ期5例。51例患者均接受了以放疗为主的治疗。体外照射予直线加速器产生的6MV或8MVX线盆腔前后野垂直轮流照射,照射剂量为盆腔正中平面40－50Gy;有3例患者辅助双侧腹股沟野照射,照射剂量45－50Gy;2例辅助外阴野照射,照射剂量30－40Gy。腔内治疗应用WD－HDR18治疗机,11例在阴道盒治疗时部分应用了Buchler治疗机。治疗时,根据肿瘤部位、大小、厚度等情况分别或联合应用阴道盒、阴道塞子、宫腔管或组织间插植针进行治疗。结果：患者的总5年生存率为58．8％,其中I期80．0％,Ⅱ期76．9％,Ⅲ期65．2％,Ⅳ期5例中0例。各期5年生存率均高于本院报道的传统的以腔内镭疗为主治疗原发性阴道癌的疗效。结论：高剂量率近距离放疗单独应用或与体外照射等联合应用治疗原发性阴道癌可取得不低于传统腔内镭疗的疗效,而且并发症发生率无明显提高。

Outcome with intracavitary high-dose-rate brachytherapy for primary vaginal cancer

OBJECTIVE: To evaluate the efficacy of radiation therapy on primary vaginal cancer with high-dose-rate brachytherapy alone or in combination with external radiation. METHODS: Fifty one cases with primary vaginal cancer who were treated with high-dose-rate brachytherapy alone or in combination with the external radiation in Cancer Hospital, Chinese Academy of Medical Sciences from 1989 to 1999 were retrospectively studied, including stage I 10 cases, stage II 13 cases, stage III 23 cases and stage IV 5 cases. WD-HDR18 after-loading equipment was used in the brachytherapy and 6 or 8 MV linear accelerator was used in the external radiation. RESULTS: The overall 5-year survival rate with WD-HDR18 was 58.8%, with 80.0% for stage I, 76.9% for stage II, 65.2% for stage III, and 0.0% for stage IV. The comparison of treatments with WD-HDR18 and radium therapy showed the 5-year survival rates of the cases of each stage treated with WD-HDR18 were higher. CONCLUSION: Treatment results obtained with high-dose-rate brachytherapy are at least similar to traditional radium therapy for primary vaginal cancer.