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目的:探讨宫颈癌体外放射治疗加后装腔内治疗的疗效和放射反应。方法:对76例宫颈癌患者均采用体外放射治疗加60Co后装腔内治疗临床资料进行回顾性分析。结果:全组5年总生存率为63.7%,Ⅰ期生存率为88.9%,Ⅱ期为71.9%,Ⅲ期为48.1%,Ⅳ期为20.0%。10年总生存率为31.6%,Ⅰ期生存率为53.3%,Ⅱ期为33.3%,Ⅲ期为22.0%,Ⅳ期为0.0%,经Log Rank法检验各期生存率有显著差异(P<0.01)。放射治疗后发生阴道粘连9例(11.8%),放射性膀胱炎6例(7.9%),放射性直肠炎13例(17.1%)。放射性直肠炎按RTOG晚期放射损伤分级方案分级,1级7例(53.8%),2级4例(30.8%),3级2例(15.4%),4级0例(0.0%)。结论:体外放射治疗加60Co后装腔内治疗宫颈癌疗效肯定,副作用少。但如何进一步提高生存率,尽可能减少放射反应仍是今后研究的方向。
Objective: To investigate the curative effect and radiation response of cervical cancer after external radiation therapy plus after cavity therapy. Methods: 76 cases of cervical cancer patients were treated with external beam radiotherapy plus 60Co after the clinical data were retrospectively analyzed. Results: The overall 5-year overall survival rate was 63.7%, stage Ⅰ survival rate was 88.9%, stage Ⅱ was 71.9%, stage Ⅲ was 48.1%, stage Ⅳ was 20.0%. The 10-year overall survival rate was 31.6%. The survival rate of stage Ⅰ was 53.3%, stage Ⅱ was 33.3%, stage Ⅲ was 22.0% and stage Ⅳ was 0.0% 0.01). Vaginal adhesions occurred in 9 cases (11.8%), radiation cystitis in 6 cases (7.9%) and radiation proctitis in 13 cases (17.1%). Radiologic proctitis was classified according to RTOG advanced radiological injury classification. Grade 1 was 7 (53.8%), grade 2 was 4 (30.8%), grade 3 was 2 (15.4%) and grade 4 was 0 (0.0%). Conclusion: The efficacy of extracorporeal radiotherapy and intraluminal implantation of 60Co in the treatment of cervical cancer is definite with few side effects. However, how to further improve the survival rate and minimize the radiation reaction remains the direction of future research.