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目的观察252锎(252Cf)中子腔内后装加外照射治疗宫颈癌的近期疗效以及并发症的发生情况。方法选择36例未接受过任何治疗的临床分期为Ⅱ、Ⅲ期的宫颈癌患者,其中Ⅱa期6例,Ⅱb期18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6～10 Gy/次,1次/周,共4～6次,使宫旁A点累积剂量达30～42 Gy。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,1.8～2.0 Gy/次,4次/周,外照射20～34 Gy后,盆腔野中间挡铅4 cm,使总剂量达到45～50 GY,总疗程5～7周。结果36例患者均随访2年,2年局部控制率为97%,2年生存率为92%,其中Ⅱa期100%,Ⅱb期94%,Ⅲa期88%,Ⅲb期75%。放射性膀胱炎发生率6%,放射性直肠炎发生率8%。结论252Cf中子腔内后装加外照射治疗宫颈癌,患者能较好耐受,同常规γ射线后装治疗比较,临床Ⅱ、Ⅲ期患者近期疗效好,并发症发生率低。
Objective To observe the short-term curative effect and complication of 252 锎 (252Cf) neutron inlay with external irradiation for cervical cancer. Methods Thirty - six patients with stage Ⅱ and Ⅲ cervical cancer who had not received any treatment were selected, including 6 cases of stage Ⅱ a, 18 cases of stage Ⅱ b, 8 cases of stage Ⅲa and 4 cases of stage Ⅲb. 252Cf neutron cavity afterloading treatment, uterine A dose of 6 to 10 Gy / time, 1 time / week, a total of 4 to 6 times, so that the cumulative dose of uterine A point up to 30 ~ 42 Gy. All pelvic extracorporeal irradiation and neutron afterloading were carried out in the same period. After the post-treatment, external irradiation was not performed on the day before and after the operation, and the area of the pelvic area was 1.8-2.0 Gy / times and 4 times / week. Lead 4 cm, so that the total dose of 45 ~ 50 GY, the total course of treatment of 5 to 7 weeks. Results All 36 patients were followed up for 2 years. The 2-year local control rate was 97% and the 2-year survival rate was 92%. Among them, 100% in stage Ⅱa, 94% in stage Ⅱb, 88% in stage Ⅲa and 75% in stage Ⅲb. Radiation cystitis incidence of 6%, the incidence of radiation proctitis 8%. Conclusions 252Cf neutron cavity posterior loaded with external irradiation for the treatment of cervical cancer, patients with better tolerance, compared with conventional γ-ray after-treatment, clinical Ⅱ, Ⅲ patients with short-term curative effect is good, the complication rate is low.