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目的初步探讨调强放疗(IMRT)治疗复发性宫颈癌的近期疗效及并发症的发生情况。方法收集重庆市肿瘤研究所2004年4月至2007年1月间实施 IMRT 治疗复发性宫颈癌患者21例(观察组)的临床资料,并以同期采用盆腔前后野照射治疗的复发性宫颈癌患者18例作为对照组。比较两组患者的近期疗效和并发症的发生情况。结果观察组完成外照射肿瘤剂量为(50±11)Gy,对照组完成外照射肿瘤剂量(39±5)Gy,两组比较,差异无统计学意义(P>0.05);观察组的有效率为71%(15/21),对照组为39%(7/18),两组比较,差异有统计学意义(P<0.05);观察组平均生存时间为(25±6)个月,对照组为(12±5)个月,两组比较,差异有统计学意义(P<0.05)。观察组无Ⅲ级以上的急性放射性胃肠道、泌尿生殖道反应发生,2例出现Ⅲ度骨髓抑制;对照组无Ⅲ级以上的急性放射性胃肠道、泌尿生殖道反应及Ⅲ度以上骨髓抑制发生。结论 IMRT 治疗复发性宫颈癌的近期疗效优于盆腔前后野照射,且其近期并发症的发生率并不增加。
Objective To investigate the short-term efficacy and complications of IMRT in the treatment of recurrent cervical cancer. Methods The clinical data of 21 patients with recurrent cervical cancer who underwent IMRT from April 2004 to January 2007 in Chongqing Cancer Institute were collected. The patients with recurrent cervical cancer treated with pelvic anterior and posterior field radiotherapy 18 cases as a control group. The curative effect and complication of the two groups were compared. Results The external tumor dose (50 ± 11) Gy in the observation group and the external tumor dose (39 ± 5) Gy in the control group showed no significant difference (P> 0.05). The effective rate of the observation group (71/21) in the control group and 39% (7/18) in the control group. The difference between the two groups was statistically significant (P <0.05). The average survival time in the observation group was (25 ± 6) months. Group (12 ± 5) months, the difference between the two groups was statistically significant (P <0.05). In the observation group, there was no acute radioactive gastrointestinal and genitourinary reaction of grade Ⅲ or higher and grade Ⅲ myelosuppression in 2 cases. There was no acute radioactive gastrointestinal and genitourinary reaction of grade Ⅲ or higher and grade Ⅲ or higher bone marrow suppression occur. Conclusions IMRT is superior to pelvic anterior and posterior irradiation in the treatment of recurrent cervical cancer, and its incidence of recent complications does not increase.