后装腔内插植放疗与三维后装腔内放疗治疗局部晚期宫颈癌的疗效与剂量学比较

目的探讨后装腔内插植放疗与三维后装腔内放疗治疗局部晚期宫颈癌的疗效与剂量学差异。方法将212例局部晚期宫颈癌患者,按照治疗方法的不同分为A组(106例)和B组(106例)。在体外三维适形调强放疗的基础上,A组采用后装腔内插植放疗,B组采用三维后装腔内放疗。对比两组近期疗效、并发症发生率以及剂量学差异。结果B组患者高危临床靶区D100、D90和中危临床靶区D100、D90均明显低于A组,膀胱、直肠、乙状结肠的D2cm3均明显高于A组,差异均有统计学意义(P﹤0.01)。A组患者总有效率明显高于B组,放射性直肠炎、放射性膀胱炎发生率均明显低于B组,差异均有统计学意义(P﹤0.01)。结论后装腔内插植放疗能够在提升肿瘤组织受照剂量的同时,降低危及器官的受照剂量,提升近期缓解率、控制率,减少不良反应。

Comparison of efficacy and dosimetry of after-loading intracavitary interstitial brachytherapy and three-dimensional image-based after-loading intracavitary brachytherapy in the treatment of locally advanced cervical cancer

Objective To investigate the efficacy and dosimetric difference of after-loading intracavitary interstitial brachytherapy and three-dimensional(3D)image-basedafter-loading intracavitary brachytherapy in the treatment of locally advanced cervical cancer.Method The study included 212 patients with locally advanced cervical cancer which were treated with either after-loading intracavitary interstitial brachytherapy(group A,n=106)or 3D image-based after-loading intracavitary brathytherapy(group B,n=106)on the basis of 3D conformal intensity-modulated radiation therapy(3DIMRT).The two groups were compared for short-term efficacy,incidence of complications and dosimetric differences.Result The D100 and D90 for high-risk clinical target volume(CTV),D100 and D90 for intermediate-risk CTV in group B were significantly lower compared to group A,besides,the D2cm3 concerning bladder,rectum,sigmoid colon were all significantly higher in group B than in group A(P<0.01).Group A had significantly improved overall response rate versus group B,with lower incidence of radiation proctitis and radiation cystitis in group A than in group B,the difference were of statistical significance(P<0.01).Conclusion After-loadingintracavitary brachytherapy increases the exposure dose of tumor tissue while minimizes the radiation dose of organ at lower risk,thereby improving the short-term response rate and control rate,with reduce adverse reactions.