宫颈癌术后螺旋断层放疗与常规调强放疗近期疗效分析

目的探讨宫颈癌术后螺旋断层放疗(helical tomotherapy,HT)与常规调强放疗(intensity-modulated radiation therapy, IMRT)近期疗效.方法228例宫颈癌术后放疗患者,HT组153例、IMRT组75例.盆腔淋巴引流区照射46-50.4Gy/23-28F;高危淋巴引流区60Gy/25-28F;残留肿瘤及肿大淋巴结64-66Gy/25-28F.阴道后装放疗2-3次,每次黏膜表面剂量8Gy.采用RTOG(radiation therapy oncology group)和EROTC(European organization for research on treatment of cancer)评分标准评价直肠和膀胱放疗反应及1-3年生存率.结果放疗期间HT组和IMRT组1级直肠反应为28.76%和42.67%(χ2=4.381, P=0.036);膀胱反应为10.46%和17.33%(χ2=2.143,P=0.143),两组均无≥2级急性放疗反应发生.HT组和IMRT组1、2、3年生存率分别为94.22%、89.13%、85.21%和93.86%、81.84%、71.11%(P=0.327).结论宫颈癌术后放疗急性反应HT组明显低于IMRT组,1-3年生存率两组差异无统计学意义.

Short-term curative effect of helical tomotherapy and conventional intensity- modulated radiotherapy for cervical carcinoma after operation

Objective To study the short-term curative effect of helical tomotherapy(HT) and conventional intensity-modulated radiotherapy(IMRT)for cervical carcinoma after operation.Methods Two hundred and twenty-eight patients with cervical carcinoma were divided into HT group(n=153) and IMRT group(n=75).Lymph nodes in their pelvic drainage region and high risk drainage region,residual tumor and enlarged lymph nodes were irradiated 46-50 at the dose of 4Gy/23-28F,60Gy/25-28F and 6466Gy/25-28F,respectively.All patients received vagina after-loading brachytherapy at the dose of 8Gy on the surface of mucous membrane for 2-3 times.Response of bladder and rectum to radiotherapy were assessed following the radiation therapy oncology group(RTOG) and European organization for research on treatment of cancer(EPRTC) scoring criteria.The 1-3 year survival rate of the patients was analyzed after HT and IMRT.Results The grade 1 response of rectum and bladder to HT and IMRT was 28.76% and 42.67%(χ2=4.381,P=0.036),and 10.46% and 17.33%(χ2=2.143,P=0.143),respectively.No acute grade ≥ 2 response to HT and IMRT occurred in two groups.The 1-,2-and 3-year survival rate of patients after HT and IMRT was 94.22%,89.13%,85.21% and 93.86%,81.84%,71.11%,respectively(P=0.327).Conclusion The acute response to HT is significantly lower than that to IMRT with no significant difference in the 1-3 year survival rate between the two groups.