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目的:探讨图像引导调强放疗+腔内近距离放疗联合顺铂方案及调强适形放疗+腔内近距离放疗联合顺铂方案治疗中晚期宫颈癌的优劣。方法:回顾性分析2010-2016年梅州市人民医院收治的中晚期宫颈癌,50例采取图像引导调强放疗+腔内近距离放疗联合顺铂方案(IGRT组)治疗,50例采取调强适形放疗+腔内近距离放疗联合顺铂方案(IMRT组)治疗,比较两组近期疗效、急性不良反应发生率。结果:IGRT组完全缓解率为94%,部分缓解率为6%,高于IMRT组(完全缓解率88%,部分缓解率12%);IGRT组Ⅱ级+Ⅲ级皮肤黏膜反应、急性消化道反应、急性泌尿系反应及骨髓抑制的发生率分别为:30%、16%、28%、24%;IMRT组Ⅱ级+Ⅲ级皮肤黏膜反应、急性消化道反应、急性泌尿系反应及骨髓抑制的发生率分别为:32%、36%、30%、46%。两组皮肤黏膜反应及急性泌尿系反应差异无统计学意义(P>0.05),IGRT组骨髓抑制及急性消化道反应小于IMRT组(P<0.05)。结论:图像引导调强放疗+腔内近距离放疗联合顺铂方案治疗中晚期宫颈癌近期疗效确切,优于调强适形放疗+腔内近距离放疗联合顺铂方案,且毒副反应小,有利于治疗的顺利完成。
Objective: To investigate the advantages and disadvantages of image-guided intensity modulated radiotherapy plus intracavity brachytherapy combined with cisplatin regimen and intensity modulated conformal radiotherapy with intracavity brachytherapy combined with cisplatin in the treatment of advanced cervical cancer. Methods: A retrospective analysis of 2010-2016 in Meizhou People’s Hospital admitted to advanced cervical cancer, 50 cases of image-guided intensity modulated radiotherapy + intracavitary brachytherapy combined with cisplatin regimen (IGRT group) treatment, 50 cases to take IMRT Radiotherapy + intracavitary brachytherapy combined with cisplatin (IMRT group) treatment, the two groups of short-term efficacy, the incidence of acute adverse reactions. Results: The complete remission rate was 94% and the partial remission rate was 6% in IGRT group, which was higher than that in IMRT group (complete remission rate was 88%, partial remission rate was 12%); grade I and III mucosal response, acute digestive tract The incidences of reaction, acute urinary reaction and myelosuppression were 30%, 16%, 28% and 24% respectively. The skin and mucosal responses of Grade I and III, acute gastrointestinal reactions, acute urinary reaction and myelosuppression The incidence rates were: 32%, 36%, 30%, 46%. There were no significant differences in mucocutaneous response and acute urinary reaction between the two groups (P> 0.05). The bone marrow suppression and acute digestive tract reaction in IGRT group were less than those in IMRT group (P <0.05). Conclusion: The results of image-guided intensity modulated radiotherapy + intracavitary brachytherapy combined with cisplatin regimen in the treatment of advanced cervical cancer have the better curative effect in the near future, which is better than the intensity modulated conformal radiotherapy + intracavitary brachytherapy combined with cisplatin solution with less toxic side effects, Is conducive to the successful completion of treatment.