252锎中子后装加外照射治疗老年子宫颈癌的疗效观察

目的观察252锎（252Cf）中子腔内后装加外照射治疗对老年宫颈癌的近期疗效以及并发症的发生情况。方法选择31例未接受过任何治疗的临床分期为Ⅱ、Ⅲ期的老年宫颈癌患者,其中Ⅱb期19例,Ⅲa期8例,Ⅲb期4例。252Cf中子腔内后装治疗,宫旁A点剂量为6～10Gy／次,1次／周,共4～6次,使宫旁A点累积剂量达30～42Gy。：全盆腔外照射和中子后装同期进行,后装治疗当天不进行外照射,前后对穿野,2．0Gv／次,4次／周,外照射24—34Gy后,盆腔野中间挡铅4em,使总剂量达到45～50Gy,总疗程5～7周。结果31例患者均随访2年,2年局部控制率为90％,2年生存率为87％,其中Ⅱb期89％,Ⅲa期88％,Ⅲb期75％。放射性膀胱炎发生率3％,放射性直肠炎发生率6％。结论252锎中子近距离治疗宫颈癌有良好的临床疗效,且并发症少,有较好的临床使用前景。

Effects of 252californium neutron brachytherapy combined with external beam radiotherapy on elderly cervical cancer

Objective To observe 2S2californium （252 Cf） neutron intracavitary plus external beam radiotherapy equipment in short term efficacy and complications of cervical cancer. Methods Thirty -one cases of elderly cervical cancer, Ⅱb stage 19 cases, Ilia stage 8 cases, Ⅲb stage 4 cases, diagnosed by FIGO, were enrolled in this study. 252 Cf brachytherapywas delivered at 6 - 10 Gy/fraction, perweek, the total dose of reference point A was 30 -42 Gy in 4 -6 fractions. The whole pelvic cavity was irradiated with 8 mV X -ray, 2.0 Gy/fraction, 4 times per week. The total dose of external beam radiotherapywas 45 -50 Gy（the center of whole pelvic field was blocked by 4 cm in width after 24 -34 Gy ） , the total treatment course was 5 - 7 weeks. Results The follow - up of all cases were 2 years. The local control rate was 90% , the overall 2 year smwival rate was 87% , with 89% in Ⅱb stage, 88% in Ⅲa stage and 75% in Ⅲb stage. The late radiation complication rate was 3% for cystitis, 6% for proctitis. Conclusions brachytherapy is cervical cancer with 252 Californium neutron an effective remedy for few complications, and is promising in clinical treatment of cervical cancer.