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目的 观察2 52 锎中子腔内后装治疗宫颈癌的近期疗效以及并发症的发生情况 ,对该治疗方案进行初步评价。方法 选择 5 1例未曾接受过任何治疗的临床分期为Ⅱ、Ⅲ期的宫颈癌患者作为研究对象 ,其中Ⅱa期 8例 ,Ⅱb期 31例 ,Ⅲa期 8例 ,Ⅲb期 4例。治疗方案 :2 52 锎中子腔内后装治疗 ,宫旁A点 ,10～ 12Gy/次 ,1次 /周 ,共进行 3～ 4次 ,该治疗间歇穿插全盆腔外照射 ,前后对穿野 ,2 0 0cGy/次 ,4次 /周 ,外照射 2 0～ 30Gy后 ,盆腔野中央屏蔽挡铅 4cm ,2 0 0cGy/次 ,4次 /周 ,使总剂量达到 4 5～ 5 0Gy ,总疗程约 5～ 6周。结果 5 1例患者均随访 2年 ,肿瘤的完全消退时间平均 2 5d ,2年局部控制率为 10 0 % ,2年生存率为 92 %。其中 ,临床分期Ⅱa期者 2年生存率为 8例中 8例 ,Ⅱb期中97% (30 / 31) ,Ⅲa期为 8例中 6例 ,Ⅲb期为 4例中 3例 ;肿瘤直径≥ 4cm者为 94 % (30 / 32 ) ,<4cm者为 19例中 17例。放射性膀胱炎、放射性直肠炎发生率均为 2 % (1/ 5 1)。结论 2 52 锎中子腔内后装治疗临床分期Ⅱ、Ⅲ期的宫颈癌具有局部控制率高、治疗时间短、患者放射治疗后并发症发生率低等特点 ,具有一定的临床应用前景
Objective To observe the short-term curative effect and complication of 2 52 锎 neutron afterloading in treatment of cervical cancer and to evaluate the treatment plan. Methods Fifty-one patients with stage II and III cervical cancer who had never received any treatment were selected as study subjects, including 8 cases of stage IIa, 31 cases of stage IIb, 8 cases of stage IIIa and 4 cases of stage IIIb. Treatment options: 2 52 锎 neutron cavity afterloading treatment, uterine A point, 10 ~ 12Gy / time, 1 / week, a total of 3 to 4 times, the treatment of interstitial interstitial intervention, before and after the wild , 2 0 0cGy / time, 4 times / week, external beam irradiation 20 ~ 30Gy, the pelvic field shielding block lead 4cm, 200cGy / times, 4 times / week, the total dose of 45 ~ 50Gy, total Course of about 5 to 6 weeks. Results All 51 patients were followed up for 2 years. The complete regression of tumor was 25 days on average. The 2-year local control rate was 100% and the 2-year survival rate was 92%. Among them, the 2-year survival rate of stage Ⅱa in clinical stage was 8 of 8 cases, 97% of stage Ⅱb (30/31), 6 of 8 cases of stage Ⅲa, 3 of 4 cases of stage Ⅲb, 94% (30/32), <4cm were 19 cases in 17 cases. Radiation cystitis, radiation proctitis incidence was 2% (1/5 1). Conclusion 2 52 锎 neutron afterloading in clinical stage Ⅱ, Ⅲ of cervical cancer with local control rate, short treatment time, the incidence of postoperative patients with low incidence of radiation therapy, has some clinical application prospects