中晚期宫颈癌三维适形放疗联合同步化疗的 临床观察

 目的评价三维适形放疗联合同步化疗在治疗中晚期宫颈癌中的临床疗效及不良反应。方法62例中晚期宫颈癌患者,随机分为外照射后三维适形放疗联合同步化疗组（A 组）和外照射结合后装联合同步化疗组（B 组），盆腔大野照射（36～40）Gy/20次后, A组三维适形照射,总剂量达66～75Gy左右； B组中央铅挡盆腔照射宫旁补量,使外照射B点剂量达45～50Gy；后装治疗补充A点剂量30Gy左右(4～7Gy/次, 1～2次/周)。A、B组均同步GP（吉西他滨+顺铂）方案化疗，3周为一疗程,共2疗程。 结果A组32例,CR 24例,PR 7例,近期有效率96.88%；B组30例, CR 15例,PR 8例, 近期有效率76.67%，A组明显高于B组(P<0.05)。骨髓抑制以及直肠、膀胱晚期放疗损伤发生率A组明显低于B组(P<0.05)。结论外照射后程三维适形放疗联合同步化疗,能提高中晚期宫颈癌的局部控制率，降低远期放疗损伤发生率。

Clinical Observation of Three Dimension Conformal Radiotherapy with Concurrent Chemoradiotherapy for Middle and Advanced Cervical Cancer

Objective To evaluate the effect and toxic reaction of three dimensional conformable radiotherapy(3D-CRT)after whole pelvic radiotherapy with concurrent chemoradiotherapy on middle and advanced cervical cancer.Methods Sixty-two patients with middle or advanced cervical cancer were divided randomly into 3D-CRT after whole pelvic radiotherapy with concurrent chemoradiotherapy(A group)and afterloading irradiation after whole pelvic radiotherapy with concurrent chemoradiotherapy(B group).After receiving 36~40Gy...