宫颈癌术后调强放射治疗联合同步化疗的效果评价

目的 评价调强放射治疗(intensity modulated radiation therapy,IMRT)联合同步化疗对宫颈癌患者术后的局部控制率、生存率及毒副作用.方法 将80例宫颈癌术后患者按治疗方法不同分为2组:常规组35例采用常规放疗(6MV-X线,总剂量45～50 GY)；调强组45例采用调强放疗(6MV-X线,总剂量45～50 GY).2组同期采用TP方案化疗4次.观察2组患者1、3、5年的局部控制率、生存率和毒副作用的发生情况.结果 调强组1、3、5年局部控制率为100.0％、95.5％、90.7％,均高于常规组的97.1％、91.4％、68.8％,1年和3年局部控制率2组比较差异无统计学意义(P＞0.05),5年局部控制率2组比较差异有统计学意义(P＜0.05)；调强组1、3、5年生存率为100.0％、97.8％、93.1％；均高于常规组的97.1％、96.9％、72.7％,1年和3年生存率2组比较差异无统计学意义(P＞0.05),5年生存率2组比较差异有统计学意义(P＜0.05).常规组骨髓抑制、放射性膀胱损伤、放射性直肠损伤较调强组发生率明显升高,2组比较差异有统计学意义(P ＜0.05).结论 调强放射治疗联合TP方案同步化疗能提高宫颈癌术后疗效,降低毒副作用,提高患者的生活质量.

Postoperative Intensity Modulated Radiation Therapy Combined with Concurrent Chemotherapy in Treatment of Cervical Cancer

Objective To evaluate the local control rate, survival rate and toxic side effects of the combined treatment with postoperative intensity modulated radiation therapy （IMRT） and concurrent chemotherapy in patients with cervical cancer. Methods Eighty patients with cervical cancer were treated with 6 MV X-ray for conventional radiotherapy （conventional group, n=35） or IMRT （IMRT group, n=45）. The total radiation dose was 45-50 Gy. TP chemotherapy program was repeated 4 times in both groups. The local control rate, survival rate and toxic side effects were compared between the two groups. Results The 5-year local control rate in IMRT group was significantly higher than that in conventional group （90.7% vs 68.8%, P〈0.05）. There were significant differences in 1-year and 3-year local control rates between the two groups （100.0% vs 97.1% and 95.5% vs 91.4%, respectively; P〉 0.05）. The 5-year survival rate in IMRT group was significantly higher than that in conventional group （93.1% vs 72.7%, P〈0.05）. There were significant differences in 1-year and 3-year survival rates between the two groups （100.0% vs 97.1% and 97.8% vs 96.9%, respectively; P〉0.05）. In addition, the incidences of bone marrow suppression, bladder injury and rectal injury in conventional group were significantly higher than those in IMRT group（P〈0.05）. Conclusion Postoperative IMRT combined with TP concurrent chemotherapy can increase therapeutic efficacy, reduce side effects and improve quality of life in patients with cervical cancer.