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目的评价三维适形(3DCRT)与调强放射治疗(IMRT)在中晚期宫颈癌治疗中的临床疗效及放疗副反应。方法将2011年12月至2012年7月新疆医科大学附属肿瘤医院收治的105例Ⅱb-Ⅳa期宫颈癌患者,随机分为IMRT组及三维适形放射治疗组,同步给予铂类为主化疗及后装放疗,观察两种治疗方法近期疗效和毒副反应。结果两组治疗近期疗效相当(P>0.05)1年生存率(OS)、无局部复发生存率(LRFS)和无远处转移生存率(DMFS)的差异无统计学意义(P>0.05);IMRT组肿瘤靶区平均剂量和3DCRT组无显著差异(P>0.05)危及器官如直肠、膀胱、小肠、乙状结肠、股骨头、双肾及脊髓等受照射剂量及体积均低于3DCRT组(P<0.01);IMRT组急慢性放射性直结肠炎及放射性膀胱炎发病率均低于3DCRT组(P<0.05);IMRT组骨髓抑制发生率略低于3DCRT组,但差异无统计学意义(P>0.05)。结论 IMRT与3DCRT治疗宫颈癌近期疗效相同,但IMRT能更好地保护正常器官,有效降低放射损伤。
Objective To evaluate the clinical efficacy and side effects of three-dimensional conformal (3DCRT) and IMRT in the treatment of advanced cervical cancer. Methods From December 2011 to July 2012, 105 patients with stage IIb-IVa cervical cancer admitted to Cancer Hospital of Xinjiang Medical University were randomly divided into IMRT group and 3D conformal radiotherapy group. After the installation of radiotherapy, to observe the short-term efficacy and toxicity of the two treatment methods. Results There was no significant difference in one - year survival rate, LRFS and DMFS between the two groups (P> 0.05). The dose and volume of irradiated organ such as rectum, bladder, small intestine, sigmoid colon, femoral head, bilateral kidney and spinal cord were all lower than those in 3DCRT group (P < 0.01). The incidence of acute and chronic radiation enterocolitis and radiation cystitis in IMRT group was lower than that in 3DCRT group (P <0.05). The incidence of bone marrow suppression in IMRT group was slightly lower than that in 3DCRT group (P> 0.05 ). Conclusion IMRT and 3DCRT have the same curative effect on cervical cancer, but IMRT can better protect normal organs and reduce radiation injury effectively.