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目的研究调强放疗、腔内治疗并同步化疗治疗中晚期(ⅡB—ⅢB)宫颈癌的疗效及毒副反应。方法选择宫颈癌患者60例,随机分为调强组(调强放疗,腔内放疗结合同步化疗,30例),常规组(常规四野箱式外照射,腔内放疗结合同步化疗,30例)。治疗方法 :调强组给予56～60Gy剂量,常规组予50～54Gy盆腔照射。腔内放疗:A点给予5Gy/次,2次/周,共6～8次。所有病人接受多西他赛和顺铂同步化疗,每3周一次,共3个疗程。比较临床疗效和急性、晚期毒副反应。结果两组病人资料类似。中位随访时间是47个月。调强组与常规组的1,2,3年生存率分别为90.0%,86.7%,80.0%以及86.7%,70.0%,60.0%;两组比较差异没有显著性(P>0.05)。调强组中有7例(23.33%)患者复发,常规组有17例(56.67%)复发,两组比较差异有统计学意义(P<0.05)。常规组中3,4级急性和晚期消化道反应和泌尿道反应的发生率比调强组高,差异有统计学意义(P<0.05)。血液骨髓毒副反应的比较,两组结果相似。结论调强放疗结合腔内放疗并同步多西他赛、顺铂化疗,是治疗局部晚期宫颈癌有效的方法 。
Objective To investigate the efficacy and side effects of intensity modulated radiotherapy, endovascular therapy and concurrent chemotherapy in the treatment of advanced cervical cancer (ⅡB-ⅢB). Methods Sixty patients with cervical cancer were randomly divided into two groups: control group (intensity modulated radiotherapy, intracavitary radiotherapy combined with concurrent chemotherapy, 30 patients), conventional group (conventional four - field external beam radiotherapy combined with intracavitary radiotherapy combined with synchronous chemotherapy, 30 cases) . Treatment: Tiaomeng group given 56 ~ 60Gy dose, conventional group to 50 ~ 54Gy pelvic irradiation. Endoluminal radiotherapy: A point to give 5Gy / time, 2 times / week, a total of 6 to 8 times. All patients received docetaxel and cisplatin concurrent chemotherapy, once every 3 weeks, a total of 3 courses. Comparison of clinical efficacy and acute, late toxic and side effects. Results The two groups of patients with similar information. The median follow-up time was 47 months. The 1, 2, 3-year survival rates were 90.0%, 86.7%, 80.0% and 86.7%, 70.0% and 60.0% in control group and conventional group respectively. There was no significant difference between the two groups (P> 0.05). There were 7 patients (23.33%) in the tonic group and 17 patients (56.67%) in the conventional group. The difference between the two groups was statistically significant (P <0.05). The incidence of grade 3, 4 acute and advanced gastrointestinal and urinary tract reactions in the conventional group was higher than that in the IMRG group, with significant difference (P <0.05). Bone marrow toxicity side effects, the two groups of similar results. Conclusions Tiaoduan radiotherapy combined with intracavitary radiotherapy and simultaneous docetaxel and cisplatin chemotherapy are effective methods for the treatment of locally advanced cervical cancer.