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目的对比调强放疗后程三维腔内后装与常规放疗后程二维腔内后装治疗原发性阴道癌的疗效与不良反应。方法将该院收治的43例原发性阴道癌患者按照治疗方法分为调强放疗后程三维腔内后装治疗组20例(调强放疗组),常规放疗后程二维腔内后装治疗组23例(常规放疗组),比较两组患者的治疗效果及不良反应。结果调强放疗组和常规放疗组的客观有效率(ORR)、疾病控制率(DCR)、2年局部复发率、2年远处转移率、2年生存率分别为90.00%、95.00%、5.00%、15.00%、90.00%和73.91%、95.65%、13.04%、8.70%、91.30%。两组患者的ORR、DCR、2年局部复发率、2年远处转移率、2年生存率比较,差异无统计学意义(P>0.05)。在早期并发症中,调强放疗组骨髓抑制、放射性阴道炎、直肠炎、膀胱炎的发生率与常规放疗组相当,且均为1~2级。在晚期并发症中,调强放疗组3~4级放射性膀胱炎(P=0.002)、阴道炎(P=0.005)反应比常规放疗组更轻。结论调强放疗与常规放疗的疗效相当,但在晚期并发症中,调强放疗后程三维腔内后装治疗放射相关的3~4级不良反应发生率低,值得推荐。
Objective To compare the curative effects and side effects of two dimensional intracavitary after-loaded treatment of primary vaginal cancer after tonoplasty and routine three-dimensional intracavitary posterior in conventional intensity-modulated radiotherapy. Methods Forty-three patients with primary vaginal cancer admitted to our hospital were divided into two groups according to the method of treatment: 20 cases (IMRT group) after IMRT and 2-dimensional intracavitary after-treatment group Twenty-three patients (conventional radiotherapy group) were enrolled in this study. The therapeutic effects and adverse reactions of the two groups were compared. Results The objective effective rate (ORR), disease control rate (DCR), 2-year local recurrence rate, 2-year distant metastasis rate and 2-year survival rate were 90.00%, 95.00% and 5.00 %, 15.00%, 90.00% and 73.91%, 95.65%, 13.04%, 8.70%, 91.30%. There was no significant difference between the two groups in ORR, DCR, 2-year local recurrence rate, 2-year distant metastasis rate and 2-year survival rate (P> 0.05). In the early complications, IMRT group bone marrow suppression, radiation vaginitis, proctitis, cystitis incidence and conventional radiotherapy group, and are 1 to 2. In advanced complications, grade 3 to 4 radiotherapy cystitis (P = 0.002) and vaginitis (P = 0.005) responded more strongly in the IMRT group than in the conventional radiotherapy group. Conclusions IMRT is equivalent to conventional radiotherapy. However, in late complications, the incidence of grade 3 or 4 radiation-related adverse reactions is low after IMRT three-dimensional intracavitary posterior treatment, which is worth recommending.