三维适形放疗治疗子宫颈癌50例近期临床观察

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目的探讨三维适形放疗治疗宫颈癌的近期疗效及放疗并发症的发生情况。方法对50例宫颈癌患者行三维适形放疗,其中包括初治患者28例(初治组),宫颈癌治疗后复发或转移9例,放疗后未控13例;并将初治组与同期行常规照射放疗的宫颈癌患者30例(对照组)进行对比,观察两组患者的近期疗效和放疗并发症的发生情况。结果初治组近期有效率为96%(27/28),对照组为97%(29/30),两组比较,差异无统计学意义(P>0.05);放疗后未控患者三维适形放疗后有效率为92%(12/13),进展1例;宫颈癌治疗后复发或转移的9例患者中7例症状缓解,有效率为7/9。初治组直肠反应发生率为46%(13/28),对照组为80%(24/30),两组比较,差异有统计学意义(P<0.05);初治组骨髓抑制发生率为71%(20/28),对照组为63%(19/30),两组比较,差异无统计学意义(P>0.05),但Ⅲ度骨髓抑制的发生率两组(分别为0和13%)比较,差异有统计学意义(P<0.05);初治组膀胱反应发生率为7%(2/28),对照组为3%(1/30),两组比较,差异无统计学意义(P>0.05)。结论三维适形放疗治疗宫颈癌与常规照射放疗的近期疗效相似,而近期放疗并发症发生率低;对于放疗后未控、治疗后复发或转移患者三维适形放疗可以作为一种行之有效的方法使用。 Objective To investigate the short-term effect of three-dimensional conformal radiotherapy for cervical cancer and the incidence of radiotherapy complications. Methods Fifty patients with cervical cancer underwent three-dimensional conformal radiotherapy, including 28 newly diagnosed patients (untreated group), 9 recurrent or metastatic cervical cancer patients and 13 uncontrollable patients after radiotherapy. 30 cases of cervical cancer who underwent routine radiation therapy were compared with each other to observe the short-term curative effect and the incidence of radiotherapy complications in both groups. Results The initial effective rate was 96% (27/28) in the initial treatment group and 97% (29/30) in the control group. There was no significant difference between the two groups (P> 0.05) After radiotherapy, the effective rate was 92% (12/13) and 1 case of progression. Among the 9 patients who recurred or metastasized after cervical cancer, the symptoms were relieved in 7 of 7 patients. The effective rate was 7/9. The incidence of rectal reaction was 46% (13/28) in the newly diagnosed group and 80% (24/30) in the control group, with significant difference between the two groups (P <0.05). The incidence of myelosuppression was 71% (20/28) in the control group and 63% (19/30) in the control group. There was no significant difference between the two groups (P> 0.05), but the incidence of grade Ⅲ myelosuppression was 0 and 13 %), The difference was statistically significant (P <0.05); the incidence of bladder reaction in initial treatment group was 7% (2/28) and that in control group was 3% (1/30). There was no significant difference between the two groups Significance (P> 0.05). Conclusion Three-dimensional conformal radiotherapy for cervical cancer is similar to conventional radiotherapy in the near future, but the incidence of recent radiotherapy complications is low. Three-dimensional conformal radiotherapy for patients with recurrent or metastatic disease after radiotherapy can be used as an effective Method used.
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