中晚期宫颈癌三维适形与调强放射治疗的临床研究

目的评价三维适形（3DCRT）与调强放射治疗（IMRT）在中晚期宫颈癌治疗中的临床疗效及放疗副反应。方法将2011年12月至2012年7月新疆医科大学附属肿瘤医院收治的105例Ⅱb-Ⅳa期宫颈癌患者,随机分为IMRT组及三维适形放射治疗组,同步给予铂类为主化疗及后装放疗,观察两种治疗方法近期疗效和毒副反应。结果两组治疗近期疗效相当（P〉0.05）1年生存率（OS）、无局部复发生存率（LRFS）和无远处转移生存率（DMFS）的差异无统计学意义（P〉0.05）;IMRT组肿瘤靶区平均剂量和3DCRT组无显著差异（P〉0.05）危及器官如直肠、膀胱、小肠、乙状结肠、股骨头、双肾及脊髓等受照射剂量及体积均低于3DCRT组（P〈0.01）;IMRT组急慢性放射性直结肠炎及放射性膀胱炎发病率均低于3DCRT组（P〈0.05）;IMRT组骨髓抑制发生率略低于3DCRT组,但差异无统计学意义（P〉0.05）。结论 IMRT与3DCRT治疗宫颈癌近期疗效相同,但IMRT能更好地保护正常器官,有效降低放射损伤。

Clinical Study of 3 Dimensional Conformal Radiationtherapy and Intensity-modulated Radiationtherapy for Patients with Cervical Cancer

Objective To evaluate the clinical efficacy and side effects of 3 dimensional conformal radiation therapy （3DCRT） and intensity-modulated radiation therapy（IMRT）on cervical cancer patients. Methods 105 patients who were admitted at the Affiliated Tumor Hospital of Xinjiang Medical University,from 2012.1 to 2012.7 and were di- agnosed with stage ]l b-IV a cervical cancer were randomized into IMRT group and 3DCRT group. The patients all re- ceived radiotherapy concurrent with chemotherapy of cisplatin and CT-image based intracavitary brachytherapy. The clinical efficacy and side effects were evaluated in both groups. Results The two groups had the same short-term effi- cacy. There was no significant difference between the two groups in the one-year overall survival（OS）,local recur- rence-freesurvival（LRFS） and distance metastasis-freesurvival（DMFS）（P~0.05）. The irradiated dose of tumor vol- ume had no significant difference between two groups（P~0.05） but the irradiated doses of the rectum,and bladder in IMRT group were significantly less than in 3DCRT group（P~0.01）. The incidence of acute and chronic radiation- induced enteritis as well as chronic radiation-induced cystitis in IMRT group was significantly lower than in 3DCRT group（P〈0.05）. The bone marrow toxicity seemed lower in IMRT group than in 3DCRT group but there was not significant difference between two groups. Conclusion IMRT is a better therapeutic option for cervical cancer pa- tients as It can considerably minimize radiation-induced side effects without compromising on the end results.