90例子宫颈癌调强放疗联合三维近距离治疗的疗效分析

Curative Effect Analysis of 90 Cases of Cervical Cancer Adopting Intensity Modulated Radiation Therapy Combining 3D Brachytherapy Treatment

摘要: 目的：探讨调强放射治疗(intensity odulated radiation therapy, IMRT)联合三维近距离治疗(3D Brachytherapy Treatment, 3D-BT)宫颈癌的临床疗效及毒副反应。方法：回顾性分析90例Ⅱb期~Ⅲb期非手术宫颈癌患者采取全盆腔IMRT + 三维近距离治疗 + 同步化疗的1、2、3年生存率及局部控制率。外照射总量：50.4~56.35 Gy；三维近距离治疗5次(6.25 GyEGD2)。随访采用门诊复查联合电话随访。结果：90例患者1、2、3年生存率，分别为92.22%、84.44%、80%。局部控制率为93.3%。消化系统早期未出现III级以上毒副反应，晚期出现III级分、毒副反应2例。泌尿系统早期未出现III级以上毒副反例，晚期III级毒副反应1例。结论：中晚期宫颈癌IMRT联合三维近距离治疗及同步化疗具有较好耐受性，1、2、3年生存率分别达92.22%、84.44%、80%，IMRT可作为宫颈癌治疗进一步发展方向。

Abstract: Objective: To discuss the clinical effects and side effects of intensity modulated radiation therapy combining 3D Brachytherapy Treatment on treating cervical cancer. Method: A retrospective analysis was made on 1-, 2-, 3-year survival rate and local control rate of 90 cases of II b period - III b period non-surgical cervical cancer patients who adopted whole pelvic IMRT+3D-BT+ concur- rent chemotherapy. Total external irradiation amount: 50.4 - 56.35 Gy; 3D Brachytherapy Treat- ment 5 times (6.25 GyEGD2). The follow-up visits adopted outpatient review and telephone follow- up. Result: Among 90 cases, 1-year survival rate is 92.22%, 2-year is 84.44%, 3-year is 80%. And the local control rate is 93.3%. There is no side effects over III levels in the digestive system at the early stage. Two cases suffered from III level side effects at the later stage. There is no side effects over III levels in the urinary system at the early stage. One case suffered from III level side effects at the later stage. Conclusion: Middle and later stage cervical cancer IMRT combining 3D-BT and concurrent chemotherapy have good tolerance. The survival rates of 1-, 2-, 3-year are separately 92.22%, 84.4% and 80%. IMRT can be the further developing direction of cervical cancer treat-ment.