252锎中子后装加外照射治疗子宫颈癌的疗效观察

目的观察252锎（252Cf）中子腔内后装加外照射治疗宫颈癌的近期疗效以及并发症的发生情况。方法选择36例未接受过任何治疗的临床分期为Ⅱ、Ⅲ期的宫颈癌患者，其中Ⅱa期6例，Ⅱb期18例，Ⅲa期8例，Ⅲb期4例。252Cf中子腔内后装治疗，宫旁A点剂量为6—10Gy／次，1次／周，共4～6次，使宫旁A点累积剂量达30～42Gy。全盆腔外照射和中子后装同期进行，后装治疗当天不进行外照射，前后对穿野，1．8—2．0Gy／次，4次／周，外照射20—34Gy后，盆腔野中间挡铅4cm，使总剂量达到45～50GY，总疗程5—7周。结果36例患者均随访2年，2年局部控制率为97％，2年生存率为92％，其中Ⅱa期100％，Ⅱb期94％，Ⅲa期88％，Ⅲb期75％。放射性膀胱炎发生率6％，放射性直肠炎发生率8％。结论252Cf中子腔内后装加外照射治疗宫颈癌，患者能较好耐受，同常规γ射线后装治疗比较，临床Ⅱ、Ⅲ期患者近期疗效好，并发症发生率低。

Effects of Neutron Brachytherapy Combined External Beam Radiotherapy on Cervical Cancer

Objective To evaluate the curative effect and complication of 252Cf intracavitary brachytherapy on cervical cancer. Methods Thirty six cases of cervical cancer, Ⅱ a ：6cases,Ⅱ b：18 cases, Ⅲa：8cases, Ⅲ b ：4cases,diagnosed by FIGO,were enrolled in this study. 252 Cf brachytherapy was delivered at 6-10 Gy/fraction per week, the total dose of reference point A was 30-42 Gy in 4-6 fractions. The whole pelvic cavity was irradiated with 8 MV X-ray, 1.8-2.0 Gy/fraction,4 times per week. The total dose of external beam radiotherapy was 45-50 Gy（ the center of whole pelvic field was blocked by 4 cm in width after 20-34 Gy） , the total treatment course was 5-7 weeks. Results The follow-up of all cases were 2 years. The local control rate was 97% ,the o- verall 2 year survival rate was 92%. In particular, Ⅱ a：6/6 cases,Ⅱ b：17/18 cases, Ⅲ a ：7/8 cases, m b：3/4 cases. The late radiation complication rate was 6% for cystitis,8% for proctitis. Conclusion Combination of 252Cf brachytherapy and external beam radiotherapy can be well-tolerated by cervical cancer patients. The 2-year survival rate for stage Ⅱ and Ⅲ patients is high with lower incidence of complications.