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目的探讨三维适形放疗结合腔内后装放疗在宫颈癌治疗中的疗效。方法将包头市某医院2004年5月至2006年5月对收治的82例Ⅱ期以上宫颈癌患者通过治疗方式不同分为两组,一组为三维适形放疗结合腔内后装放疗治疗组,病例数为43例,使90%等剂量曲线包绕靶区,肿瘤剂量45Gy,腔内照射5～6次,A点总剂量75～81Gy。另一组为单纯三维适形放疗治疗组,病例数为39例,肿瘤剂量55～60Gy。结果三维适形放疗结合腔内后装放疗治疗组43例宫颈癌患者总有效率为97.7%。单纯三维适形放疗治疗组39例宫颈癌患者总有效率为84.6%。两组总有效率比较差异有统计学意义(P<0.05);三维适形放疗结合腔内后装放疗治疗组3年以上生存率76.7%,1年以上生存率100%。单纯三维适形放疗治疗组3年以上生存率61.5%,1年以上生存率94.9%。两组1、3年生存率比较差异无统计学意义(P>0.05)。结论三维适形放疗结合腔内后装放疗治疗宫颈癌可提高靶区剂量,周围器官得到有效保护,放射反应小,治疗精度高,显著提高了肿瘤局部控制率和生存率,提高患者对放疗的耐受性。
Objective To investigate the effect of three-dimensional conformal radiotherapy combined with endovascular radiotherapy in the treatment of cervical cancer. Methods From May 2004 to May 2006 in Baotou City, 82 patients with stage Ⅱ or higher cervical cancer were divided into two groups according to different treatment methods. One group was treated with three-dimensional conformal radiotherapy combined with intracavitary posterior radiation therapy , The number of cases was 43 cases, the 90% isodose curve wrapped around the target area, the tumor dose of 45Gy, intracavitary irradiation of 5 to 6 times, A total dose of 75 ~ 81Gy. The other group was a simple three-dimensional conformal radiotherapy treatment group, the number of cases was 39 cases, the tumor dose of 55 ~ 60Gy. Results The total effective rate of 43 cases of cervical cancer was 97.7% in three-dimensional conformal radiotherapy combined with intracavitary after-radiotherapy. 39 patients with simple cervical cancer treated with three-dimensional conformal radiotherapy had a total effective rate of 84.6%. The total effective rate was significantly different between the two groups (P <0.05). The three-dimensional conformal radiotherapy combined with intracavitary posterior radiation therapy had a survival rate of more than 3 years 76.7% and a one-year survival rate 100%. Simple three-dimensional conformal radiotherapy group more than 3 years survival rate of 61.5%, 1 year survival rate of 94.9%. There was no significant difference in the 1, 3-year survival rates between the two groups (P> 0.05). Conclusion Three-dimensional conformal radiotherapy combined with intracavitary posterior radiation therapy for cervical cancer can increase the target dose, the surrounding organs are effectively protected, the radiation response is small, the treatment accuracy is high, the tumor local control rate and survival rate are significantly increased, and the patients’ Tolerance.