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目的 :比较不同方法后装治疗宫颈癌的远期放疗反应 ,探讨各种方法的合理应用。方法 :三组后装治疗病人均采取宫腔、阴道分上的方法 ,并配合外照射治疗。A组C组参照曼彻斯特法参考点均取A点 ,A组宫腔阴道对A点剂量贡献比为 1∶1,C组宫腔阴道对A点剂量贡献比 1.5～ 2 .4∶1;B组参照巴黎方法 ,参考点均取源轴中心外 2cm处 ,宫腔阴道组织受量比为 1∶1。结果 :三组疗效基本相近 ,差异无显著性 (P >0 .0 5)。远期放疗反应以阴道粘连最为常见 ,A组 36 / 4 2 (85.71% ) ,B组 4 / 86(4 .6 5% ) ,C组 (4 .17% ) ,A组显著高于B组和C组 (P <0 .0 1) ,B组和C组差异无显著性 (P >0 .0 5)。结论 :宫颈癌腔内治疗疗效确切可靠 ,但在腔内治疗各种方法的灵活应用上有时需注意 ,如参考点的设置、宫腔阴道剂量配比等 ,在采取宫腔、阴道分上参考点均取A点时 ,应结合病变范围及机器情况调整增加宫腔阴道对A点的剂量比例 (勿取 1∶1,本院用 1.5～ 2 .4∶1) ,以减少直肠、膀胱并发症。
OBJECTIVE: To compare the long-term radiotherapy response of different methods of post-treatment for cervical cancer and explore the rational application of various methods. Methods: Three groups of post-treatment patients were taken uterine and vaginal points on the method, and with external irradiation therapy. A group C reference points refer to the Manchester method point A, A group of uterine cavity dose to the point A ratio of 1: 1, C group of uterine cavity dose to A dose ratio of 1.5 to 2. 4: 1; B Group reference Paris method, the reference point are taken 2cm at the center of the source axis, uterine cavity by the ratio of 1: 1. Results: The efficacy of the three groups was similar, but the difference was not significant (P> 0.05). Long-term radiotherapy was the most common vaginal adhesions in group A, 36/42 (85.71%) in group A, 4/86 (4.65%) in group B and 4.17% in group C And group C (P <0. 01). There was no significant difference between group B and group C (P> 0.05). Conclusion: The curative effect of endovascular treatment of cervical cancer is accurate and reliable, but sometimes it is necessary to pay attention to the flexible application of various methods of endovascular treatment, such as the setting of reference point, the ratio of intrauterine vaginal dose and so on. Points are taken A point, should be combined with the extent of the lesion and the machine to adjust the situation to increase the dose of the uterine cavity to the point A ratio (do not take 1: 1, 1.5 ~ 2. 4: 1), to reduce the rectum, bladder complications disease.