三维适形放射治疗联合紫杉醇每周方案化学治疗中晚期宫颈癌疗效观察

目的观察三维适形放射治疗联合紫杉醇每周方案化学治疗不能手术的中晚期宫颈癌临床疗效和副作用。方法选择临床确诊为ⅡB~ⅢB期中晚期宫颈癌患者100例,年龄30~81岁,平均年龄45.00岁。对照组40例进行全盆腔前后两野对穿照射。治疗组60例采用真空垫固定、CT模拟机定位,勾画肿瘤靶区(GTV)、临床靶区(CTV)和计划靶区(PTV),进行三维适形放射治疗,所有患者放射治疗期间同步紫杉醇单药治疗,药物剂量75mg/m2,每周1次。观察同步放化疗的近远期疗效和副作用。结果 60例治疗组宫颈癌患者总有效率为85.00%(51/60),与对照组有效率57.50%(23/40)比较,差异有显著统计学意义(P0.05)。治疗组患者1、2、3年生存率分别为100.00%(60/60)、100.00%(60/60)、96.67%(58/60),对照组患者1、2、3年生存率分别为100.00%(40/40)、90.00%(36/40)和85.00%(34/40)。统计学分析发现,二者差异无统计学意义(P0.05)。治疗组中晚期放射治疗反应主要为Ⅰ~Ⅱ级,无4级不良反应发生。结论与盆腔普通放射治疗相比较,三维适形放射治疗联合紫杉醇每周方案化学治疗中晚期宫颈癌有较高的有效率,不良反应轻,患者易耐受,且操作易行。

Three-dimensional conformal radiation therapy combined with weekly Paclitaxel chemotherapy efficacy in treatment of advanced cervical cancer

Objective To observe the clinical curative efficacy and side effects of the inoperable patients with uterine cervix cancer in middle and advanced-stage treated with three-dimensional conformal radiation therapy （3D-CRT） and weekly Paclitaxel chemotherapy. Methods A total of 100 advanced cervical cancer patients with IIB - ⅢB stages were enrolled, which aged 30 - 81 years old with mean age of 45.00. All of them were divided into 2 groups, control group （n = 40）.was performed before and after two whole pelvic radiation. The treatment group（n = 60） was fixed by vacuum pad and positioned by CT simulator, the outline the tumor target（GTV）, clinical target volume（CTV） and planning target volume（PTV） were draw and performed by three-dimensional conformal radiotherapy. All patients was treated by radiation therapy and single drug taxol chemical treatment（the chemotherapy dose 75 mg/m2） once a week simultaneously. The curative and side effect of simultaneous chemotherapy and synchronous radiation in short and long term were observed. Results The total efficiency in treatment group was 85.00 %（51/60）, and in control group was 57.50 %（23 / 40）, there was significant difference between 2 groups（P〈 0.05）. The 1, 2, 3-year survival rates in treatment group were 100.00 %（60/60）, 100.00 %（60/60） and 96.67 %（58/60）; Those in control group were 100.00 %（40/40）, 90.00 %（36/40） and 85.00 %（34/40）, respectively. But there was no statistically significant between 2 groups（P 〉 0.05）. Sooner or later radiotherapy reaction in treatment group was grade I - II, without grade 4 adverse reaction occurred. Conclusion It is demonstrated that comparison of ordinary pelvic radiotherapy, 3D- CRT combining with weekly Paclitaxel chemotherapy in the treatment of advanced cervical cancer have better local control rate, milder adverse reactions and tolerance, and the operation is much easier.