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目的探讨宫颈癌腔内放疗的疗效及并发症。方法110例患者均采用腔内后装放疗加体外照射的方法。先给予体外全盆照射,每次每照射野用2 Gy,盆腔中心总剂量为20～26 Gy,然后于全盆大野中间用铅档,面积4 cm)<14 cm,4 cm×15 cm,每次照射野2 Gy,4次/周,宫旁总剂量为20～26Gy;同时给予腔内后装治疗,1次/周,阴道与官腔的治疗分别进行,每次A点剂量5～6 Gy,总剂量30～35 Gy,对大的外生型肿瘤,给于肿瘤消失量5～10 Gy。结果110例患者3年生存率为81.8%,其中Ⅱ期和Ⅲ期3年生存率分别82.1%、79.3%。本组36例(32.7%)表现持续性便血或伴有下坠感,或因便血而致贫血,其中,l例(0.9%)有直肠阴道瘘。膀胱阴道瘘2例(1.8%),其中l例(0.9%)与肿瘤相关,膀胱反应l2例(10.9%)。结论腔内后装放疗对宫颈癌是一种很有效的治疗方法,掌握好放疗方法及剂量,可提高治愈率、减少并发症。
Objective To investigate the efficacy and complications of cervical cancer radiotherapy. Methods 110 patients were treated with intracavitary posterior radiation plus external irradiation method. The total volume of pelvic cavity was 20-26 Gy, and then all the pots were placed in the middle of the area. The area was 4 cm) <14 cm, 4 cm × 15 cm, Each irradiation field 2 Gy, 4 times / week, the total parametrial dose of 20 ~ 26Gy; at the same time given intracavitary after treatment, 1 / week, respectively, vaginal and bureaucratic treatment, each time A dose of 5 to 6 Gy, the total dose of 30 ~ 35 Gy, for large exogenous tumor, give the tumor disappearance of 5 ~ 10 Gy. Results The 3-year survival rate was 81.8% in 110 patients. The 3-year survival rates of stage Ⅱ and stage Ⅲ were 82.1% and 79.3% respectively. The group of 36 patients (32.7%) showed persistent blood in the stool or accompanied by a sense of falling, or anemia caused by blood in the stool, of which 1 case (0.9%) had rectovaginal fistula. In 2 cases (1.8%) of vesicovaginal fistula, 1 case (0.9%) was associated with tumor and 12 cases (10.9%) with bladder reaction. Conclusion Intracavitary posterior radiation therapy is a very effective treatment for cervical cancer. To master the radiotherapy methods and dosage can improve the cure rate and reduce the complications.