252锎中子后装加全盆外照射治疗宫颈癌临床观察

目的：观察全盆外照射加252锎腔内后装治疗宫颈癌的近期疗效、晚期并发症情况，对治疗方案加以总结。方法：选择32例初治的临床分期为Ⅰb～Ⅲb期宫颈癌患者作为研究对象，其中Ⅰb期5例，Ⅱa期9例，Ⅱb期8例，Ⅲa期5例，Ⅲb期5例。治疗方案：252锎中子腔内后装治疗，宫旁A点剂量为7～10Gy／次，1次／周，共进行4～6次，使宫旁A点累积剂量达35～45Gy；同时进行前后对穿野全盆腔外照射200cGy／次，4次／周；外照射20～30Gy后，盆腔野中央屏蔽挡铅3～4cm，继续四野外照射200cGy／次，4次／周，使外照射总剂量达到45～50Gy。总疗程约需5～7周。结果：32例患者分别于2年及3年进行随访，其2年和3年局部控制率和总生存率均分别为100％（32／32）、90．6％（29／32），按临床分期其生存率为Ⅰb期100％（5／5），Ⅱa期100％（9／9），Ⅱb期87．5％（7／8），Ⅲa期80％（4／5），Ⅲb期80％（4／5）。放射性直肠炎发生率为6．3％，放射性膀胱炎发生率为3．1％。结论：252锎中子腔内后装加全盆外照射治疗各期宫颈癌，患者能较好耐受，且其Ⅱ、Ⅲ期患者2年及3年生存率较高而并发症发生率较低，临床应用前景乐观。

252 californium neutron breech loading adds the entire trough external irradiation to treat the cervical cancer clinical observation

Will observe the entire trough external irradiation to add in2s2 californium cavities the breech loading to treat cervical cancer the short-term curative effect, the later period complication situation, to will treat the plan to summarize. Methods：Chooses 32 at the beginning of examples to govern clinically by stages is Ⅰ b-Ⅲ The b time cervical cancer patient takes the object of study, amongⅠ b time 5 examples, Ⅱa time 9 examples, Ⅱb time 8 examples, Ⅲa time 5 examples, Ⅲb time 5 examples. Treatment plan： in 252 californium neutron cavity the breech loading treatment, nearby the palace A dosage is 7～10Gy/time, 1/week, altogether carries on 4～6 times, causes nearby the palace A accumulated dose to reach 35～45Gy; Around simultaneously carries on to puts on wild entire pelvic cavity external irradiation 200cGy/time,4/weeks;After external irradiation 20～30Gy, the pelvic cavity wild central shield keeps off lead 3～4cm, continues four open country to shine 200eGy/time, 4/weeks, enable the external irradiation integral dose to achieve 45～50Gy. The total treatment course needs 5～7 weeks approximately. Results：32 example patients separately carry on the revisit in 2 year and 3 years,its 2 years and 3 year partial inverse amplification factors and the total survival rate respectively are 100% （a2/32）,90.6% （29/32）,according to clinical its survival rate is by stages Ⅰb time 100%（5/5）, Ⅱa time 100M （9/9）, Ⅱb time 87.5% （7/8）, Ⅲa time 80% （4/5）, Ⅲb time 80% （4/5）. The radioactive proetitis formation rate is 6.3% ,the radioactive cystitis formation rate is 3. 1%. Conclusion： 232 californium neutron cavity the breech loading adds the entire trough external irradiation to treat various issue of cervical cancer, the patient can good endure,also it Ⅱ ,Ⅲ But the time patient 2 years and 3 year survival rates are high the complication formation rate to be low.the clinical oractiee nrospect is ontimistic.