论文部分内容阅读
目的:观察调强放疗(IMRT)加腔内治疗宫颈癌的疗效及放射损伤的情况。方法:106例(ⅡB?ⅣA)首治宫颈癌,采取全盆腔IMRT,GTV总量:59.4～64.4Gy;CTV总量:48.6～53.2Gy。完成调强放疗后再行3～4次的腔内治疗,使得A点的总量达74.4～82Gy(调强放疗+腔内治疗)。结果:1、2年总生存率分别为100%及92.31%、无病生存率为:97.30%、88.46%。放疗中出现的放射损伤均较轻,最早出现的反应为恶心及呕吐、食欲减退、厌油,总发生率为27.36%;放疗2周后反应主要为腹泻,总发生率29.25%;直肠及膀胱反应多在放疗后期出现,发生率分别为:16.04%及4.72%。仅发现2例放射性直肠炎,无放射性膀胱炎发生。结论:宫颈癌IMRT+腔内治疗可以得到很好的治疗效果;肠道及膀胱急性放射损伤均较轻;直肠及膀胱的放射并发症很低。IMRT剂量学的优势是否可以转化为较低的放射并发症及很好的治疗效果,还需要大量病例的长期随访及验证。
Objective: To observe the effect of IMRT plus endovascular treatment of cervical cancer and the situation of radiation injury. Methods: One hundred and six cases (ⅡB? ⅣA) were treated with cervical IMRT. The total pelvic IMRT was used. The total amount of GTV was 59.4-64.4 Gy. The total CTV was 48.6-53.2 Gy. Complete IMRT and then 3 to 4 times the endovascular treatment, making the total amount of A point 74.4 ~ 82Gy (IMRT + endovascular treatment). Results: The overall survival rates at 1 year and 2 years were 100% and 92.31% respectively, and the disease-free survival rates were 97.30% and 88.46%. Radiation injury occurred in radiotherapy were lighter, the first reaction was nausea and vomiting, loss of appetite, tired of the oil, the total incidence was 27.36%; 2 weeks after radiotherapy, the reaction was mainly diarrhea, the total incidence of 29.25%; rectum and bladder Reactions were mostly in the late radiotherapy, the incidence rates were: 16.04% and 4.72%. Only 2 cases of proctitis were found, and no radiation cystitis occurred. Conclusion: IMRT + endovascular treatment of cervical cancer can get good therapeutic effect; intestinal and bladder acute radiation injury are lighter; rectal and bladder radiation complications are low. Whether the advantages of IMRT dosimetry translate into lower radiation complications and good therapeutic outcomes also requires long-term follow-up and validation in a large number of cases.