| 史颖,茹亚,宋丽华,等.不同加量调强放疗方案在 Ⅱb~Ⅲb期宫颈癌治疗中的疗效及安全性比较[J].安徽医药,2018,22(10):1943-1946. |
| 不同加量调强放疗方案在 Ⅱb~Ⅲb期宫颈癌治疗中的疗效及安全性比较 |
| Comparison of efficacy and safety of different intensity modulated radiation therapy in stage Ⅱb-Ⅲb cervical cancer |
| 投稿时间：2018-05-04 |
| DOI： |
| 中文关键词: 宫颈肿瘤 淋巴转移 放射疗法,调强适形 放射剂量分次 顺铂 治疗结果 |
| 英文关键词: Uterine cervical neoplasms Lymphatic metastasis Radiotherapy,intensity-modulated Dose fractionation Cisplatin Treatment outcome |
| 基金项目:国家自然科学基金(81660429) |
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| 中文摘要: |
| 目的 探讨后程与同期加量调强放疗方案治疗宫颈癌合并盆腔淋巴结转移的疗效及安全性差异。 方法 研究对象选取陕西中医药大学第二附属医院2012年1月至2013年12月收治的宫颈癌合并盆腔淋巴结转移患者共80例,根据随机数字表法分为后程组(40例)和同期组(40例),分别在铂类化疗基础上同步给予后程与同期加量调强放疗方案治疗,比较两组患者近期疗效、中位总生存时间(OS)、无进展生存时间(PFS)、远处转移时间(DMR)、随访复发转移率、危及器官放射剂量及毒副作用发生率等。 结果 同期组近期治疗客观缓解率97.50%显著高于后程组80.00%(χ2=6.135,P<0.05)；同期组中位OS、PFS及DMR分别为23.6、16.8、19.1个月,后程组分别为18.3、13.5、15.4个月,同期组均长于后程组(χ2=6.355、3.846、4.859,P<0.05)；同期组患者野内淋巴结复发率为5.00%,显著低于后程组22.50%(χ2=5.165,P<0.05)；同期组患者小肠最大放射剂量(Dmax)、直肠Dmax及膀胱1cc体积(D1cc)放射剂量分别为(54.73±6.05)Gy、(54.10±5.89)Gy、(54.26±7.18)Gy,后程组分别为(62.12±8.31)Gy、(65.32±7.66)Gy、(68.70±9.53)Gy,同期组均低于后程组(t=4.547、6.166、7.564,P<0.05)；同期组患者骨髓抑制发生率35.00%显著低于后程组65.00%(χ2=7.200,P<0.05)。 结论 相较于后程加量方案,同期加量调强放疗方案治疗合并盆腔淋巴结转移宫颈癌可有效控制肿瘤进展,改善远期生存率,避免远期转移,且有助于降低骨髓抑制发生风险。 |
| 英文摘要: |
| Objective To explore the clinical effects and safety differences of simultaneous integrated boost and late course boost radiotherapy synchronous with platium in the treatment of cervical cancer combined with metastatic pelvic/para-aortic lymph nodes. MethodsEighty patients with cervical cancer combined with metastatic pelvic/para-aortic lymph nodes admitted to The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2012 to December 2013 were chosen.The patients were randomly assigned into two groups,group A (n=40) with late course boost radiotherapy and group B (n=40) with simultaneous integrated boost radiotherapy on the basis of platinum.The short-term clinical efficacy,the median time of overall survival (OS),progression free survival (PFS) and distant metastasis (DMR),the metastasis and recurrence rate,the radiology dose of organ injury and the drug side effects incidence of both groups were compared. Results The objective remission rate of group Bin radiotherapy completion (97.50%) was significantly higher than group A(80.0%)(χ2=6.135,P<0.05).The median time of OS,PFS and DMR of group Bwas 23.6 mo,16.8 mo,and 19.1 mo,respectively,while they in group Awere 18.3 mo,13.5 mo and 15.4 mo,respectively; the median time of OS, PFS and DMR of group Bwas significantly longer than those in group A(χ2=6.355,3.846 and 4.859,respectively;P<0.05).The metastasis rate in the range of radiotherapy of group B(5.00%) was significantly lower than that in group A(22.50%)(χ2=5.165,P<0.05).The maximum radiology dose (Dmax) for small intestine,rectum and the radio dose for 1cc (D1cc) of bladder was(54.73±6.05)Gy,(54.10±5.89) Gy,(54.26±7.18) Gy in group A,and they were(62.12±8.31) Gy,(65.32±7.66) Gy,(68.70±9.53)Gy in group B;those of group Bwere significantly fewer than that in group A(t=4.547, 6.166 and 7.564,respectively;P<0.05).The incidence of bone marrow suppression of group B(35.0%) after treatment was significantly lower than group A(65.0%)(χ2=7.200,P<0.05). Conclusions Compared with late course boost radiotherapy,simultaneous integrated boost radiotherapy synchronous with platium in the treatment of cervical cancer combined with metastatic pelvic/para-aortic lymph nodes can effectively control disease progression,prolong the survival time,reduce the risk of lymph nodes metastasis and be helpful to decrease the degree of bone marrow suppression. |
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