分段加速超分割放射治疗晚期宫颈癌的毒副反应

目的 了解分段加速超分割放射治疗的毒副反应.方法 于1998年6月-2001年2月分别采用全盆常规放疗(A组)、全盆分段加速超分割放疗(B组)、全盆分段加速超分割放疗同时联合化疗(C组)治疗Ⅱb期以上宫颈鳞癌,对放疗毒副反应和治疗效果进行临床比较研究.结果 1)5年生存率及局部控制率3组分别为39.29%(11/28)及57.14%(16/28);52.17%(12/23)及69.57%(16/23);62.96%(17/27)及77.78%(21/27),有上升的趋势,差异无统计学意义(P＞0.05);2)各种近期放疗反应3组无明显差异.远期放疗反应:照射野皮下纤维化,发生率3组分别为75%(21/28)、65.22%(15/23)、70.37%(19/27);阴道闭锁和狭窄分别为A组28.57%(8/28)、B组17.39%(4/23)、C组25.92%(7/27);直肠反应;膀胱反应;比较差异无统计学意义(P＞0.05).放射性直肠炎和放射性膀胱炎均为Ⅰ～Ⅱ级,未出现Ⅱ～Ⅲ毒副反应.结论 全盆加速超分割放疗不增加放疗毒副反应,有提高生存率及局部控制率的趋势.

The Side Reaction of Split-Course Accelerated Hyperfractionated Radiotheray in Locally Advanced Cervical Cancer

Objective To know the side reaction of the split-course accelerated hyperfractionated radiotherapy(SCAHF).Methods From Jun.1998 to Feb.2001,the patients with locally advanced cervical cancer were treated in our hospital by the whole pelvic conventional fractionated radiotherapy(A group) and the whole pelvic SCAHF(B group)and the whole pelvic SCAHF plus chemotherapy(C group) separately.Results 1) The 5-year survival rate was 39.29%(11/28) in A group and 52.17 %(12/23)in B group and 62.96%(17/27)in C group,the local control rate was 57.14%(16/28)in A group and 69.57%(16/23)in B group and 77.78%(21/27)in C group.There were no significant differences(P>0.05).2)All the acute side reactions were no significant differences(P>0.05).The first reaction of the chronic toxicity was dermofibrosis within the external radiation,the second was the atresia of vagina,the third was the rectum and the fourth was the bladder,there were no significant differences of the three groups(P>0.05).Conclusions The split-course acceierated hyperfractionated radiotheray(SCAHF) did not increase the side reaction,it could tend to improve survival rate and local control rate of advanced cervical cancer.