三维适形放疗治疗早期宫颈癌的临床观察

目的探讨三维适形放疗(3DCRT)对宫颈癌的近期疗效及并发症的发生率。方法2001年1月至8月对收治的30例宫颈癌患者施行3DCRT,所有病例放疗前行CT检查,用Redplan3.5作出三维适形计划,靶区剂量DT45Gy,观察放疗近期疗效及消化道和膀胱的放疗反应。同期对照组50例同条件病例采用常规放疗技术,观察内容同3DCRT组。结果3DCRT给肿瘤区提供了较理想的靶区适合度,可提高靶区剂量,使周围正常组织如膀胱、直肠得到有效的保护,患者对放疗的耐受性提高。0级的消化道反应3DCRT组和常规放疗组分别为33%和0(P<0.01);I级消化道反应两组分别为57%和92%(P<0.01);Ⅰ级泌尿道反应两组分别为13%和16%,两组比较差异无统计学意义(P>0.05)。两组病例近期有效率和1、2年生存率比较差异无统计学意义。结论3DCRT的放疗近期有效率等同于常规放疗,急性消化道反应明显低于常规放疗组。

Three-dimensional conformal radiotherapy for early cervical cancer

Objective Compare the difference between three-dimensional conformal radiotherapy(3DCRT) and conventional radiotherapy(RT) for cervical cancer. Methods During a period of January to August thirty patients with cervical cancer received 3DCRT.All patients received a treatment planning computer tomography scan.The target volumes (of upper vagina,parametrial tissues,presacral region,uterus and regional lymph nodes) and normal tissues (bladder,and rectum) were identified.Redplan 3.5 was used.Providing coverage of the target with the prescribed dose 45 Gy.Acute gastrointestinal (GI) and genitourinary (GU) toxic effects were compared with those in 50 patient treated with conventional RT. Results 3DCRT provided excellent coverage of target,providing considerable sparing of the bladder and rectum.Grades 0 GI of 3DCRT and conventional RT were 33% and 0(P<0.01).Grades Ⅰ GI were 50% and 78%(P<0.01).Grade Ⅰ GU toxicity was lower in 3DCRT group (13% vs 16%),but no statistical significance (P>0.05). Conclusion 3DCRT proved excellent coverage of the target structure while sparing critical neighboring structures in cervical cancer.