三维适形放疗治疗子宫颈癌50例近期临床观察

目的探讨三维适形放疗治疗宫颈癌的近期疗效及放疗并发症的发生情况。方法对50例宫颈癌患者行三维适形放疗,其中包括初治患者28例（初治组）,宫颈癌治疗后复发或转移9例,放疗后未控13例;并将初治组与同期行常规照射放疗的宫颈癌患者30例（对照组）进行对比,观察两组患者的近期疗效和放疗并发症的发生情况。结果初治组近期有效率为96％（27／28）,对照组为97％（29／30）,两组比较,差异无统计学意义（P〉0．05）;放疗后未控患者三维适形放疗后有效率为92％（12／13）,进展1例;宫颈癌治疗后复发或转移的9例患者中7例症状缓解,有效率为7／9。初治组直肠反应发生率为46％（13／28）,对照组为80％（24／30）,两组比较,差异有统计学意义（P〈0．05）;初治组骨髓抑制发生率为71％（20／28）,对照组为63％（19／30）,两组比较,差异无统计学意义（P〉0．05）,但Ⅲ度骨髓抑制的发生率两组（分别为0和13％）比较,差异有统计学意义（P〈0．05）;初治组膀胱反应发生率为7％（2／28）,对照组为3％（1／30）,两组比较,差异无统计学意义（P〉0．05）。结论三维适形放疗治疗宫颈癌与常规照射放疗的近期疗效相似,而近期放疗并发症发生率低;对于放疗后未控、治疗后复发或转移患者三维适形放疗可以作为一种行之有效的方法使用。

Clinical research on the treatment of patients with cervical carcinoma using three-dimensional conformal radiotherapy

OBJECTIVE: To explore the clinical treatment effect of three-dimensional conformal radiotherapy (3DCRT) in cervical carcinoma in comparison with traditional radiotherapy. METHODS: Totally 50 cases of cervical carcinoma were treated with 3DCRT, and another 30 cases treated with routine radiotherapy were selected during the same period as the control group. The short-term treatment effect and acute reaction in both groups were observed. RESULTS: The short-term effective rates of the treatment group and the control group were respectively 96% (27/28) and 97% (29/30), with no significant difference (P > 0.05). The effective rates of patients with recurrence or metastasis were respectively 92% (12/13) and 7/9. The rate of acute radiation reaction of the rectum between the treatment group and control group were respectively 46% (13/28) and 80% (24/30), with a significant difference (P < 0.05). The rate of bone marrow depression of the two groups were respectively 71% (20/28) and 63% (19/30), with no significant difference (P > 0.05), while the rate of severe bone marrow depression between two groups showed a significant difference (0 and 13%, P < 0.05). The rates of acute radiation reaction of the bladder between two groups were respectively 7% (2/28) and 3% (1/30), with no significant difference (P > 0.05). CONCLUSION: The therapeutic effect of 3DCRT is similar to that of traditional radiotherapy in the treatment of cervical carcinoma, but the former treatment method has a lower rate of acute complications.