调强放疗联合化疗治疗宫颈癌盆腔复发的临床研究

目的探讨调强放疗联合化疗治疗宫颈癌盆腔复发的近期疗效及并发症的发生情况。方法对25例盆腔复发的宫颈癌患者,采用盆腔调强放疗联合DDP同步化疗的方法,给予患者处方剂量95%PTV:50~60Gy/25~30次/2Gy/次,放疗期间同步DDP周方案化疗,观察患者的临床疗效及不良反应。结果所有患者均完成调强放疗,阴道出血缓解率为88.9%(16/18),下肢浮肿缓解率为88.2%(15/17),腰腿疼痛缓解率为86.4%(19/22)。3个月后疗效评估,完全缓解率为52%(13/25),部分缓解率为24%(6/25),稳定率为8%(2/25),进展率为16%(4/25),有效率为76%(19/25)。近期不良反应主要为骨髓抑制、胃肠道反应及泌尿系统反应,≥Ⅲ度骨髓抑制发生率为12%(3/25),胃肠道反应和泌尿系统反应为Ⅰ~Ⅱ级,发生率分别为36%(9/25)、32%(8/25),未发生Ⅲ级及以上胃肠道反应及泌尿系统反应。结论调强放疗联合化疗治疗宫颈癌盆腔复发,能缓解患者症状,近期疗效好,不良反应可耐受。

Clinical study of intensity modulated radiotherapy combined with chemotherapy for pelvic recurrence of cervical cancer

Objective To investigate the short-term curative effect and complications of intensity modulated radiotherapy (IMRT) combined with chemotherapy for pelvic recurrence of cervical cancer. Methods Twenty-five pelvic recurrent cervical cancer patients were treated with pelvic IMRT combined with DDP simultaneous chemotherapy. The patients were given a prescribed dose of 95% PTV: 50-60 Gy/25-30 times/2Gy/time,concurrent DDP weekly chemotherapy during the radiotherapy. The clinical efficacy and side effects of the patients were observed, and the short-termcurative effect was evaluated after three months. Results All the patients completed IMRT. The vaginal bleeding remission rate was 88.9% (16/18), the lower extremity edema remission rate was 88.2% (15/17), and the waist and leg pain relief rate was 86.4% (19/22). The complete remission rate was 52% (13/25),the partial remission rate was 24% (6/25), the stability rate was 8% (2/25), the rate of progress was 16% (4/25), and the effective rate was 76% (19/25). The recent side effects of these patients were myelosuppression, gastrointestinal reactions and urinary tract reactions. The incidence of ≥3 degree myelosuppression was 12% (3/25).The gastrointestinal reaction and urinary system reaction were Grade Ⅰ-Ⅱ, the incidence rates were 36% (9/25), 32% (8/25) respectively, but there were noGrade Ⅲ and above gastrointestinal reactions and urinary system reactions. Conclusion IMRT combined with chemotherapy for pelvic recurrence of cervical cancer can well alleviate the symptoms of the patients, the recent effect is good, and the toxic side effects can be tolerated.