论文部分内容阅读
目的:Ir192腔内后装(ICRT)-Bid/d分割方式,探讨治疗宫颈的可行性与临床生物剂量效应,效果和副作用。方法:体外放疗(ExRT)+HDR-Ir192腔内放疗(Bid法),治疗71例宫颈癌患者,Ⅱb期采用全盆腔DT40Gy/4W/20F,Ⅲb期DT46GY/4.6W/23F,结束后挡铅(中央遮挡铅块5HVL,4cm宽)B点DT补量12-14GY/6-7f/1.2-1.4W。Ⅱb期、Ⅲb期A点250cGY/次×Bid/天,两次间隔≥6小时,每周间隔三天重复治疗(2d/w),总计10次/5天/2.5W,A点总量DT2500cGY。挡铅后ExRT与ICRT交替进行。结果:放疗(RT)结束时局部近期疗效CR56例,PR15例。1年生存率:80.3%(57/71)。5年生存率:54.9%(39/71)。阴道反应:Ⅰ度56.3%(40/71)Ⅱ度33.8%(24/71)Ⅲ°9.9%(7/71),无1例因反应而导致治疗计划中断。6个月后71例宫颈活检均为阴性。大小便常规无炎性及出血表现,宫颈阴道符合一般性放射反应后遗改变。结论:HDR-Ir192腔内后装超分割治疗宫颈癌,方法可行,中期疗效满意,副反应小。应用足够的分割(包括次数及剂量),是提高疗效,减少晚期并发症的关健。但晚反应组织损伤、远期生存率尚需加大样本进一步随访及评诂。
OBJECTIVE: Ir192 ICRT - Bid / d method was used to investigate the feasibility and clinical biological dose effect, effect and side effects in the treatment of cervix. Methods: 71 cases of cervical cancer were treated with ExRT + HDR-Ir192 intracavitary radiotherapy. The whole pelvis DT40Gy / 4W / 20F and Ⅲb DT46GY / 4.6W / 23F were used in stage Ⅱb. (Central block lead 5HVL, 4cm wide) B point DT fill 12-14GY / 6-7f / 1.2-1.4W. Ⅱb, Ⅲb A point 250cGY / times × Bid / day, two intervals ≥ 6 hours, three days intervals repeated treatment (2d / w), a total of 10 times / 5 days /2.5W, A point total DT2500cGY . ExRT and ICRT are blocked alternately after blocking lead. Results: The local short-term efficacy of radiotherapy (RT) CR56 cases, PR15 cases. 1 year survival rate: 80.3% (57/71). 5-year survival rate: 54.9% (39/71). Vaginal reactions: Ⅰ degree 56.3% (40/71) Ⅱ degree 33.8% (24/71) Ⅲ ° 9.9% (7/71), no one due to the reaction led to the treatment plan interrupted. 71 cases of cervical biopsies were negative after 6 months. No stool routine urine and bleeding performance, cervix and vagina in line with changes in the general after-effects of radiation. Conclusion: HDR-Ir192 intracavitary posterior hyper-segmentation of cervical cancer treatment, the method is feasible, satisfactory results in the middle, side effects. The application of adequate segmentation (including the number and dose), is to improve the efficacy and reduce the complications of late-stage. However, late response to tissue damage, long-term survival rates still need to increase the sample for further follow-up and review 诂.