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1.
目的 探讨调强放疗治疗早期子宫颈癌术后阴道残端复发的价值.方法 采用回顾性同期对照研究,对30例早期子宫颈癌术后阴道残端复发患者(试验组)行调强放疗,选择同期行常规放疗的30例早期子宫颈癌术后阴道残端复发患者为对照组,两组均行3个疗程TP方案治疗.比较两组间患者的近期疗效及并发症情况.结果 试验组完全缓解(CR) 22例,部分缓解(PR)7例,进展(PD)1例,对照组CR 14例,PR 5例,稳定(SD)7例,PD 4例,试验组有效率为96.67%(29/30),对照组有效率为63.33%(19/30),差异有统计学意义(P=0.009).试验组1例1级放射性膀胱炎,1例1级放射性肠炎;对照组3例阴道直肠瘘,1例3级放射性膀胱炎,2例2级放射性膀胱炎,2例1级放射性肠炎.结论 调强放疗治疗早期子宫颈癌术后阴道残端复发近期疗效满意,优于常规放疗,不良反应可耐受.  相似文献   

2.
Radiation proctitis and radiation cystitis are major complications for patients with cervical carcinomafollowing radiotherapy. In the present study, we aimed to determine the potential risk factors for the developmentof radiation proctitis and radiation cystitis after irradiation. A total of 1,518 patients with cervical carcinomareceived external beam radiotherapy (EBRT) followed by high-dose-rate intracavitary brachytherapy (HDRICB)in our hospital. The incidences of radiation proctitis and radiation cystitis were recorded and associations withdifferent factors (age, time period, tumor stage) were analyzed with c2 (chi-squared) and Fisher exact tests. Wefound that 161 and 94 patients with cervical carcinoma were diagnosed with radiation proctitis and radiationcystitis, respectively, following radiotherapy. The prevalence of Grade I-II radiation proctitis or radiation cystitiswas significantly lower than that of Grade III (radiation proctitis: 3.82% vs. 6.76%, P < 0.05; radiation cystitis:2.31% vs. 3.87%, P < 0.05) and was significantly enhanced in patients with late stage (IIIb) tumor progressioncompared to those in early stage (Ib, IIa) (P < 0.05). Moreover, the incidence of radiation proctitis and cystitiswas not correlated with age or, time period following radiation, for each patient (P > 0.05). These observationsindicate that a late stage of tumor progression is a potential risk factor for the incidence of radiation proctitisand cystitis in cervical carcinoma patients receiving radiotherapy.  相似文献   

3.
赵力  纪天龙  魏凤 《陕西肿瘤医学》2009,17(10):1958-1960
目的:观察调强适形放疗同步化疗治疗复发性宫颈癌的近期疗效和不良反应。方法:54例复发宫颈癌患者随机分为观察组和对照组。观察组(放化疗同步组)28例,采用调强适形放疗,同时接受至少2周期顺铂、氟尿嘧啶方案化疗,顺铂20mg/m^2静脉滴注第1—5天,氟尿嘧啶500mg/m^2静脉滴注第1—5天。对照组(单纯放疗组)26例,单用调强适形放疗。两组放疗均应用直线加速器(6MV,X线),设立5—7个共面照射野,肿瘤剂量45—50Gy。结果:观察组近期有效率(CR+PR)为92.8%,对照组近期有效率(CR+PR)为76.9%,两组比较差异有统计学意义(P〈0.05)。观察组和对照组的不良反应主要为血白细胞减少、消化道反应。观察组中急性Ⅲ。血白细胞下降发生率7.1%,急性Ⅲ。恶心、呕吐发生率3.6%,急性Ⅲ。腹泻发生率7.1%,经治疗后均缓解。对照组中无Ⅲ。以上不良反应发生。两组急性不良反应比较有统计学差异(P〈0.05)。两组患者1年生存率比较无统计学意义(P〉0.05)。结论:调强适形放疗同步顺铂、氟尿嘧啶方案化疗治疗复发性宫颈癌近期疗效较好,不增加放射损伤。  相似文献   

4.
目的:探讨阿米福汀(AMI)对直肠癌同步放化疗患者的保护作用。方法选取经病理组织学证实的直肠癌患者80例,随机分为治疗组和对照组,每组各40例。所有患者均予盆腔适形调强放射治疗及口服卡培他滨同步化疗。治疗组在同步放化疗基础上加用AMI治疗,观察两组患者的不良反应,并进行对比分析。结果治疗组Ⅱ~Ⅳ级急性直肠炎的发生率为12.5%,明显低于对照组的32.5%,差异具有统计学意义(P﹤0.05);两组患者均无Ⅲ~Ⅳ级泌尿系统不良反应发生;治疗组中性粒细胞减少发生率为22.5%,明显低于对照组的45%,差异具有统计学意义(P﹤0.05)。AMI相关不良反应有:低血压2例,Ⅲ级呕吐2例,面部温热感1例;无因AMI相关不良反应而中断治疗者。结论 AMI可预防或减轻放化疗带来的不良反应,值得临床推广应用。  相似文献   

5.
Concurrent chemoradiation therapy (CCRT) is the standard treatment for locally advanced cervical cancer. The present study aimed to compare the therapeutic responses, toxicities and dosimetric parameters between intensity-modulated radiation therapy (IMRT) and tomotherapy (TOMO) in patients with advanced cervical cancer. This retrospective study included 310 patients with stage IIB-IIIB cervical cancer who underwent CCRT, with 155 patients in each group. Intracavitary brachytherapy was performed after a course of external beam radiation therapy (EBRT), or in the last week of pelvic EBRT. The treatment planning aim at point A (defined as a reference location 2 cm above the vaginal fornix and 2 cm beside the mid axis of the uterus) was >85 Gy in an equivalent dose at 2 Gy. There was no statistical difference with regard to clinicopathological characteristics between the two groups (P>0.05). Improved dose conformity and dose homogeneity (P<0.05) were observed in TOMO planning. TOMO provided more efficacious critical organ sparing than IMRT when assessing the percentage of normal tissue receiving at least 20 Gy (V20) for the bladder, the percentage of normal tissue receiving at least 40 Gy (V40) for the femoral head, and the V40 and V20 for the rectum (P<0.05). TOMO demonstrated a greater ability to protect the ovary (P<0.05). The acute radiation toxicity of proctitis and leukopenia were significantly lower in the TOMO group (P<0.05). The chronic radiation toxicity of radiation enterocolitis and cystitis was lower in the TOMO group (P<0.05). Thus, TOMO provided better critical organ sparing than IMRT. The radiation toxicities were acceptable. Therefore, TOMO appears to be a good option for the treatment of stage IIB-IIIB cervical cancer.  相似文献   

6.
目的: 探讨宫颈癌根治术后并发无症状淋巴囊肿(pelvic lymphocyst,PL)患者进行调强放疗(intensity modulated radiotherapy,IMRT)的可行性。方法:2015年1月至2016年2月期间我科收治的宫颈癌根治术后具有放疗指征的患者共92例,根据模拟定位计算机断层扫描(computed tomography,CT)时是否发现PL分为实验组(有PL且PL直径≤6cm,46例)和对照组(无PL,46例)。实验组临床靶区(clinical target volume,CTV)勾画将全部PL包括在内,两组均采用同样的IMRT技术制定治疗计划,通过剂量体积直方图(dose volume histogram,DVH)及放疗期间周围危及器官(organ at risk,OAR)小肠、直肠、膀胱的急性反应分析PL对IMRT的影响,并观察实验组PL在放疗结束时及放疗结束后3月的转归情况。〖HTH〗结果:〖HTSS〗实验组CTV体积明显大于无PL组,差异具有统计学意义(P<0.05)。在IMRT放疗方式中,两组小肠、直肠、膀胱受照剂量体积差异无统计学意义(P>0.05)。两组小肠、直肠、膀胱的急性放射性反应差异无统计学意义(P>0.05)。实验组PL放疗结束时有效率达60.61%,放疗后3个月达89.32%。结论:宫颈癌根治术后并发无症状PL患者及时给予术后IMRT不增加放疗期间小肠、直肠、膀胱的急性放射性反应,同时可以治愈PL。  相似文献   

7.
宫颈癌术后放疗行限定骨盆IMRT计划剂量学分析   总被引:1,自引:0,他引:1  
目的 探讨宫颈癌术后放疗行限定骨盆IMRT计划(BM-sparing IMRT)对靶区剂量、OAR以及血液不良反应的影响。方法 选取10例接受术后放疗的宫颈癌患者,通过瓦里安TPS对同一图像分别行BM-sparing IMRT和常规IMRT,比较2种计划中骨盆受量差异、靶区剂量分布以及其他OAR受量差异。选取30例既往接受术后放疗的宫颈癌患者,Pearson法分析骨盆受量与骨盆冠状轴、矢状轴、垂直轴长度与体积相关性。选取41例接受术后放疗的宫颈癌患者,随机分为观察组和对照组,观察组疗前行BM-sparing IMRT计划并按要求限定骨盆受量,对照组行常规IMRT;Logistic回归分析2个组患者≥2级血液不良反应发生与骨盆受量相关性。结果 BM-sparing IMRT与IMRT均能达到CTV剂量要求,OAR受量相近(P均>0.05)。BM-sparing IMRT骨盆的Dmean、V10、V20、V40、V50均低于IMRT (P=0.003~0.045)。Pearson法相关分析结果显示骨盆的Dmean、V20、V30、V40、V50与骨盆冠状轴长呈负相关(P=0.008~0.038)。观察组患者的血液不良反应发生率明显低于对照组(P=0.019)。Logistic回归分析结果显示血液不良反应发生与骨盆V20相关(OR=1.191,P=0.042)。结论 宫颈癌术后放疗行BM-sparing IMRT能降低骨盆受量和血液不良反应发生率,骨盆受量与骨盆冠状轴长呈负相关,血液不良反应发生与骨盆V20相关。  相似文献   

8.
目的探讨早期宫颈癌手术后调强放疗(intensive radiotherapy,IMRT)和三维适形放疗(three-dimensional conformal radiotherapy,3D-CRT)治疗的效果。方法选取110例早期宫颈癌手术患者,按受试顺序平均分成2组。对照组55例术后采用3D-CRT治疗,研究组55例术后IMRT治疗,观察2组在疗效等指标上变化情况。结果研究组治疗后在血小板下降、血红蛋白下降、白细胞下降、消化系统损伤、泌尿系统损伤、放射性直肠炎及放射性膀胱炎等Ⅲ级发生率上显著低于对照组(P<0.05);2组总有效率比较差异无统计学意义(P>0.05)。对照组局部复发率16.36%、远处转移率7.27%,研究组局部复发率7.27%、远处转移率3.64%,2组比较差异显著(P<0.05)。2组治疗前生理维度、社会家庭维度、情感维度、功能维度、宫颈癌特意维度评分比较差异均不显著(P>0.05),治疗后均较治疗前显著提高(P<0.05),且研究组显著优于对照组(P<0.05)。结论早期宫颈癌术后IMRT和3D-CRT疗效相当,但IMRT不良反应相对较低,生活质量更高,复发率更低。  相似文献   

9.
目的:评估中晚期宫颈癌放疗中分别采用容积旋转调强放疗(volumetric modulated arc therapy,VMAT)和5野适形调强放疗(intensity modulated radiotherapy,IMRT)的近期疗效和不良反应。方法:选取2016年4月至2017年3月陕西省肿瘤医院首程收治112例中晚期子宫颈癌(诊断为Ⅱb-Ⅳa期)患者,随机分为VMAT和IMRT 2组,同步给予铂类增敏化疗及后装治疗,观察2种治疗方法疗效及不良反应的差异。结果:两组患者近期疗效相当,1年总体生存率、无局部复发生存率和无远处转移率两组间差异无统计学意义(P>0.05);急性放射性肠炎、急性放射性膀胱炎及骨髓抑制发生率两组间差异无统计学意义(P>0.05);远期不良反应(放射性膀胱炎及肠炎),VMAT明显优于IMRT。结论:两种放疗方法对中晚期宫颈癌近期疗效相同,但从长远意义上讲VMAT能更好的保护危及器官,有效降低放射损伤,是治疗中晚期宫颈癌的重要手段。  相似文献   

10.
Radiation-induced acute intestinal symptoms (RIAISs) are the most relevant complication of abdominal or pelvic radiation. Considering the negative impact of RIAIS on patients’ daily activities, the preventive effects of berberine on RIAIS in patients were investigated. Thirty-six patients with seminoma or lymphomas were randomized to receive berberine oral (n = 18) or not (n = 18). Forty-two patients with cervical cancer were randomized to a trial group (n = 21) and control group (n = 21). Radiotherapy used a parallel opposed anterior and posterior. 300-mg berberine was administered orally three times daily in trial groups. Eight patients with RIAIS were treated with 300-mg berberine three times daily from the third to the fifth week. Toxicities, such as fatigue, anorexia/nausea, etc., were graded weekly according to CTC version 2.0. Patients with abdominal/pelvic radiation in the control group showed grade 1 fatigue, anorexia/nausea, colitis, vomiting, proctitis, weight loss, diarrhea and grade 2 anorexia/nausea, fatigue. Only grade 1 colitis, anorexia/nausea, and fatigue were seen in patients of abdominal radiation treated with berberine. Grade 1 fatigue, colitis, anorexia/nausea, and proctitis occurred in patients of pelvic radiotherapy treated with berberine. Pretreatment with berberine significantly decreased the incidence and severity of RIAIS in patients with abdominal/pelvic radiotherapy when compared with the patients of the control group (P < 0.05). RIAIS were reduced in patients with abdominal radiotherapy/pelvic radiation after receiving berberine treatment. Berberine significantly reduced the incidence and severity of RIAIS and postponed the occurrence of RIAIS in patients with abdominal or whole pelvic radiation.  相似文献   

11.
目的 探讨3D打印微创导向模板插植放射治疗联合深部热疗治疗局部晚期宫颈癌的近期疗效和不良反应.方法 选取2018年6月至2020年12月于河北省沧州中西医结合医院治疗的80例初治宫颈癌患者,并随机分为联合治疗组及单纯治疗组,每组40例.单纯治疗组外照射采用6 MV?X加速器放疗同步顺铂化疗,后装治疗采用192Ir高剂量...  相似文献   

12.
目的 探讨常规放疗、三维适形放疗(3DCRT)、调强放疗(IMRT)治疗食管癌的疗效差异.方法 117例食管癌中,38例采用常规放疗,32例采用3 DCRT,47例采用IMRT.并对疗效和毒副反应进行比较分析.结果 常规放疗组、3DCRT组和IMRT组的有效率分别为92.1%、96.9%、91.5%,差异无统计学意义(...  相似文献   

13.
目的 探讨尼妥珠单抗联合调强放疗及周期化疗在局部晚期宫颈癌的治疗中的临床效果.方法 将80例局部晚期宫颈癌患者分为对照组和观察组.观察组患者43例,行尼妥珠单抗联合调强放疗及周期化疗治疗;对照组患者37例,行调强放疗及周期化疗.比较2组患者的临床有效率、肿瘤体积退缩情况、不良反应发生率以及局部复发和远处转移.结果 在放疗结束后3个月,宫颈癌患者治疗的总有效率观察组和对照组分别为88.4%和70.3%,观察组显著高于对照组(P<0.05);在治疗后2周,观察组患者的肿瘤体积显著小于对照组(P<0.05);在治疗后4周,2组患者肿瘤体积存在显著统计学差异(P<0.05).2组患者在治疗后1年内均有远处转移和局部复发情况发生,其中观察组患者的局部复发和远处转移发生情况显著低于对照组(P<0.05).2组患者不良反应发生情况不存在统计学差异(P>0.05).结论 尼妥珠单抗联合调强放疗及周期化疗能够显著提高局部晚期宫颈癌患者的近期疗效,快速退缩肿瘤体积,降低患者的复发率和远处转移率.  相似文献   

14.
目的 探讨IMRT在老年宫颈癌初治患者治疗中的临床应用价值。方法 选择2008年1月—2009年1月在我院收治的老年宫颈癌患者60例,其中常规放疗(CRT)组30例,IMRT组30例,比较两组患者的疗效和放疗并发症。结果IMRT组和CRT组近期有效率分别为86.7%和90.0%,差异无统计学意义(P>0.05);IMRT组1、2年生存率分别为86.7%、73.3%,CRT组1、2年生存率分别为80.0%、63.3%,差异无统计学意义(P>0.05);IMRT组较CRT组小肠、直肠、膀胱的受照射剂量和体积均明显减少(P<0.05);近期胃肠道及泌尿系放疗反应IMRT组发生率明显低于CRT组(P<0.05);远期放射性直肠炎、膀胱炎发生率明显低于CRT组,差异有统计学意义(P<0.05)。结论 IMRT技术与常规放疗方法相比对老年宫颈癌初治患者是一种更为有效的治疗手段,临床近期疗效满意,放疗并发症明显降低。  相似文献   

15.
目的:探讨高强度聚焦超声热凝技术(HIFU)结合根治性放疗、顺铂化疗治疗宫颈癌患者的近期疗效及远期预后效果。方法:回顾性分析我附院2010年1月至2013年12月收治的84例Ⅱb-Ⅲb期宫颈癌患者的临床资料,根据治疗过程中是否采用HIFU辅助治疗分为HIFU组(n=36)和放化疗组(n=48),两组患者均采用根治性放疗、顺铂化疗,HIFU组辅以HIFU技术治疗,比较两组患者的近期及远期疗效差异。结果:HIFU组患者的治疗一个月后的疗效分布显著的优于放化疗组(P<0.05),HIFU组患者的总有效率94.44%显著高于放化疗组的75.00%(P<0.05)。HIFU组患者的KPS评分提高率达到66.67%高于放化疗组的41.67%,HIFU组的获益率达到100%高于放化疗组的89.58%(P<0.05)。HIFU组患者的1、2、3年存活率分别为94.44%、86.11%、77.78%均高于同期放化疗组患者的91.67%、79.17%、60.42%,但差异不具有统计学意义(P>0.05);HIFU组患者的3年生存中位时间32个月显著长于放化疗组的28个月(P<0.05)。HIFU组和放化疗组患者的白细胞降低、恶心呕吐、放射性直肠炎、放射性膀胱炎发生率比较差异均不显著(P>0.05)。结论:HIFU结合根治性放疗、顺铂化疗治疗宫颈癌能够改善患者的近期疗效,对延长患者的生存时间具有显著效果,同时不会增加不良反应发生率。  相似文献   

16.
李霞  孔为民  陈娇  刘瑶  商若天  宋丹  焦思萌 《癌症进展》2016,14(12):1264-1267
目的:比较两种同步化疗方案联合放疗治疗中晚期宫颈癌的疗效及不良反应。方法回顾性分析138例中晚期宫颈癌患者的临床资料,按不同治疗方式分为A、B两组,其中A组为同步顺铂(DDP)化疗+放疗组(75例),B组为同步DDP+5-氟尿嘧啶(5-Fu)化疗+放疗组(63例),分析比较两组患者的近期疗效、不良反应及5年生存率。结果 A、B两组近期有效率分别为89.3%和92.1%,两组比较差异无统计学意义(P﹥0.05)。A、B两组5年生存率分别为62.7%和68.3%,两组比较差异无统计学意义(P﹥0.05)。两组的放射性直肠炎和放射性膀胱炎的发生率差异无统计学意义(P﹥0.05),而白细胞降低等3级及以上骨髓抑制不良反应A组较B组严重,恶心、呕吐等3级及以上胃肠道不良反应B组较A组严重,差异均有统计学意义(P﹤0.05)。结论 DDP与DDP+5-Fu化疗方案联合放疗治疗中晚期宫颈癌的近期疗效及远期疗效相近,但DDP化疗+放疗骨髓抑制严重,DDP+5-Fu化疗+放疗胃肠道不良反应严重。  相似文献   

17.
目的:探讨调强放疗模式下局部晚期鼻咽癌诱导化疗后同期化疗与单纯放疗临床疗效的比较。方法:回顾性分析2010年-2012年期间在本院采用调强放疗技术治疗的局部晚期鼻咽癌,分期为Ⅲ-Ⅳ期的鼻咽癌患者共120例。所有患者都进行过诱导化疗。放疗范围及剂量为鼻咽原发灶、阳性淋巴结的大体肿瘤体积处方剂量为T1、T2期69.96Gy,T3、T4期72~74Gy;亚临床高危区靶体积处方剂量为60~64Gy;淋巴结阴性引流区处方剂量为50~54Gy。分为单纯放疗组60例,同期化疗组60例。同期化疗方案为单药顺铂为基础的方案。主要观察两组的近期疗效、3年无瘤生存率(DFS)、3年无局部区域复发生存率(LRFS)、3年无远处转移生存率(MFS)、3年总生存率(OS)及治疗的毒副反应情况。结果:两组性别、年龄、病理类型及临床分期的构成比均有可比性。两组患者中位随访36个月。治疗结束3个月两组患者的完全缓解率分别为83.3%、80.0%,3年无瘤生存率分别为78.3%、75.0%,3年的无局部区域复发生存率分别为93.3%、90.0%,3年无远处转移生存分别为81.7%、83.3%,3年总生存率分别为88.3%、86.7%,两组统计学无明显差异。同期化疗组急性毒副反应高于单纯放疗组。结论:在调强放疗治疗模式下,局部晚期鼻咽癌同期化疗与单纯放疗相比,患者的3年总生存率及无瘤生存率未能进一步提高,而急性毒副反应增加,同期化疗在调强放疗模式下治疗策略需要行进一步的临床研究。  相似文献   

18.
[目的]分析肺癌患者放射治疗后急性放射性肺损伤发生的影响因素。[方法]选取171例肺癌放射治疗的患者,采用Logistic回归分析研究性别、年龄、是否化疗、放疗剂量、V5、V20、平均肺剂量(MLD)等因素与患者3级及以上急性放射性肺损伤发生率的相关性。[结果]171例肺癌放射治疗的患者中,发生3级及以上急性放射性肺损伤50例(29.3%)。单因素分析发现,吸烟、放疗前化疗周期数多、同期放化疗、V5>40%、V20>25%、V20>28%、MLD>10Gy、MLD>13Gy均可导致肺癌患者3级及以上放射性肺损伤发生率的升高。多因素分析显示,吸烟、放疗前化疗周期数多、V20>28%、MLD>13Gy与3级及以上放射性肺损伤发生率有关。[结论]在肺癌放疗计划设计中,应针对中国肺癌患者的特点,设定适合的物理参数;此外,还需考虑患者的吸烟史、化疗史等个体化因素,尽可能降低急性放射性肺损伤的发生率。  相似文献   

19.
Aim: The aim of this study was to evaluate acute adverse events and efficacy of three-dimensional intensitymodulatedradiotherapy (IMRT) combined with endocrine therapy for intermediate and advanced prostatecancer. Methods: Sixty-seven patients were treated with three-dimensional IMRT combined with maximumandrogen blockade. The correlation between radiation-induced rectal injury and clinical factors was furtheranalyzed. Results: After treatment, 21 patients had complete remission (CR), 37 had partial remission (PR), andnine had stable disease (SD), with an overall response rate of 86.5%. The follow-up period ranged from 12.5 to99.6 months. Thirty-nine patients had a follow-up time of ≥ five years. In this group, three-year and five-yearoverall survival rates were 89% and 89.5%, respectively; three-year and five-year progression-free survival rateswere 72% and 63%. In univariate analyses, gross tumor volume was found to be prognostic for survival (χ2 =5.70, P = 0.037). Rates of leucopenia and anemia were 91.1% and 89.5%, respectively. Two patients developedacute liver injury, and a majority of patients developed acute radiation proctitis and cystitis, mainly grade 1/2.Tumor volume before treatment was the only prognostic factor influencing the severity of acute radiation proctitis(P < 0.05). Conclusions: IMRT combined with endocrine therapy demonstrated promising efficacy and was welltolerated in patients with intermediate and advanced prostate cancer.  相似文献   

20.
董晶  赵西侠  舒瑾 《现代肿瘤医学》2012,20(7):1421-1423
目的:观察中药保留灌肠预防宫颈癌放射性直肠炎的疗效.方法:将86例宫颈癌放疗患者随机分为观察组40例和对照组46例,观察组采用中药保留灌肠配合放疗,对照组单纯放射治疗,观察两组放射性直肠炎的发生率.结果:所有患者中放射性直肠炎发生率18.6%,观察组出现放射性直肠炎3例(7.5%),对照组发生放射性直肠炎13例(28.2%),观察组放射性直肠炎的发生率明显低于对照组(P<0.05),有显著性差异.结论:中药保留灌肠能明显降低宫颈癌放疗患者放射性直肠炎的发生率.  相似文献   

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