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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)宫颈癌的疗效及感染因素。方法 30例中晚期宫颈癌患者,CT扫描定位,勾画靶区及其周围危险器官,设计调强计划,腔内放疗在放疗开始3周后实施:A点给予5GY/次,2次/周,共6～8次,腔内照射时用纱布填塞阴道,使其充分扩张,减少膀胱、直肠、尿道的放射损伤及继发感染;所有患者接受多西他赛和顺铂同步化疗,每3周1次,共3个疗程;观察临床疗效和急性,晚期不良反应。结果近期疗效:有效率(完全缓解+部分缓解)为96.7%,1、2、3年生存率分别为90.0%、86.7%、80.0%;晚期并发症有4例(13.33%)轻度放射性直肠炎,未出现2、3级不良反应;放射性膀胱炎2例(6.67%)。结论强调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 infection factors of intensity modulated radiotherapy, endovascular therapy and concurrent chemotherapy in the treatment of advanced cervical cancer (ⅡB ~ ⅢB). Methods Thirty patients with advanced cervical cancer underwent CT scans to outline the target area and its surrounding organs. The intensity planning was designed. After 3 weeks of radiotherapy, the intracavitary radiotherapy was performed: 5GY / time, 2 times / week, A total of 6 to 8 times, intracavitary irradiation with gauze to plug the vagina, to fully expand, reduce the bladder, rectum, urethral radiation injury and secondary infection; all patients receive docetaxel and cisplatin concurrent chemotherapy every 3 weeks 1 times, a total of 3 courses; observe the clinical efficacy and acute, late adverse reactions. Results The short-term curative effect was 96.7% with effective rate (complete remission + partial remission), 90.0%, 86.7%, 80.0% respectively in 1, 2, 3 years and 4 cases with advanced complications (13.33%). Enteritis did not appear 2,3 grade adverse reactions; 2 cases of radioactive cystitis (6.67%). Conclusions Radiation therapy combined with intracavitary radiotherapy and simultaneous docetaxel therapy is an effective method for the treatment of locally advanced cervical cancer.