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为了观察同步放化疗对中晚期宫颈癌近期临床疗效,对28例未接受过任何治疗的ⅡB～ⅣA期宫颈癌患者行252 Cf中子腔内后装加盆腔外照射同期化疗。化疗采用顺铂(DDP)30 mg,d1～d5静脉推注,5-氟尿嘧啶(5-FU)750mg,d1～d5静脉滴入,21～28d为1个周期,共用2个周期;1个周期化疗结束后2d开始采用直线加速器体外放疗,盆腔前后左右4野盒式照射,2Gy/(次.d),4次/周,组织量达30～36Gy后,盆腔野中央屏蔽挡铅4cm×10cm,继续盆腔前后2野照射,使盆腔外照射剂量达46～50Gy;期间配合252 Cf中子腔内后装治疗,宫旁A点剂量为(7～10)Gy/次,1次/周,共进行4～5次,使宫旁A点剂量达36～40Gy,中子腔内后装治疗单日不行外照射治疗。近期疗效,所有病例在治疗结束后3个月复查盆腔MR结果示仅3例未控,其余皆达到CR,1和2年生存率分别为89.28%和85.71%,主要不良反应为放射性直肠炎、放射性膀胱炎和消化道反应和骨髓抑制,以轻度为主,经处理后可恢复,无严重不良反应。初步研究结果提示,252 Cf中子腔内后装加常规外照射同期化疗治疗中晚期宫颈癌,可提高局控,不良反应可耐受,应做为中晚期宫颈癌的主要治疗手段,但长期疗效及晚期反应还需进一步观察。
In order to observe the recent clinical curative effect of concurrent chemoradiotherapy on advanced cervical cancer, 28 patients with stage ⅡB-ⅣA cervical cancer who did not receive any treatment were given 252 Cf neutron after-posterior plus pelvic external irradiation concurrent chemotherapy. Chemotherapy with cisplatin (DDP) 30 mg, d1 ~ d5 intravenous injection, 5-fluorouracil (5-FU) 750mg, d1 ~ d5 intravenous infusion, 21 ~ 28d for a cycle, sharing two cycles; After 2 days of chemotherapy, radiotherapy with linear accelerator in vitro and radiotherapy were performed in 4 pelvic anterior, posterior, lateral and lateral radiographs of 2 Gy / (times .d), 4 times / week. After the tissue volume reached 30-36 Gy, , Continue to 2 before and after pelvic irradiation, the external pelvic dose of 46 ~ 50Gy; with 252 Cf neutron cavity after loading therapy, uterus A dose (7 ~ 10) Gy / time, 1 time / week, A total of 4 to 5 times, so that the dose of the Palace A point of 36 ~ 40Gy, neutron cavity after the installation of a single day no external radiation therapy. Short-term curative effect. All cases were reviewed pelvic MR findings 3 months after the end of treatment showed that only 3 cases were not controlled, and the rest were achieved CR, 1 and 2-year survival rates were 89.28% and 85.71%, the main adverse reactions of radiation proctitis, Radiation cystitis and gastrointestinal reactions and myelosuppression, with mild, can be restored after treatment, no serious adverse reactions. Preliminary results suggest that, 252 Cf neutron cavity after the routine plus conventional external irradiation in the treatment of advanced cervical cancer, can enhance the local control, adverse reactions can be tolerated, should be used as the main treatment for advanced cervical cancer, but long-term Efficacy and advanced reactions need further observation.