根治性调强放疗宫颈癌不同治疗模式的急性反应研究

赵潇; 周桂霞; 解传滨; 葛瑞刚; 巩汉顺; 张慧娟; 杨微

doi:10.3969/j.issn.1005-1139.2012.09.005

根治性调强放疗宫颈癌不同治疗模式的急性反应研究

Change in pattern of radical intensity-modulated radiotherapy for cervical carcinoma

摘要

摘要: 目的回顾性分析调强放疗宫颈癌不同治疗模式改变及缩短总治疗时间的可行性及急性反应差异。方法 107例根治性放疗宫颈癌患者，外照射用三维适形放疗（three-dimensional conformal radiation therapy，3D-CRT）37例、常规调强放疗（intensity-modulated radiotherapy，IMRT）26例和螺旋断层放疗（helical tomotherapy，HT）44例。3D-CRT外照射40Gy/4周后加后装放疗，1次/周，总治疗时间9-10周；IMRT和HT组外照射3周后加后装放疗，2次/周，总治疗时间为6-7周；后装放疗均为6-7次。结果放疗期间膀胱Ⅰ级反应发生率在3D-CRT组、IMRT组和HT组分别为56.76%、23.08%和18.18%，3D-CRT与其他两组之间有统计学差异（χ²=6.13，P<0.05）；直肠Ⅰ级反应发生率分别为86.49%、53.85%和29.55%，各组之间均有统计学差异（χ²=10.37，P<0.01）。结论外照射采用常规IMRT和HT技术根治性放疗宫颈癌比3D-CRT缩短治疗时间2-3周，且放疗反应明显降低。

Abstract: Objective To retrospectively analyze the feasibility to change the pattern of radical cervical cancer intensity-modulated radiotherapy(IMRT) for cervical cancer and shorten its treatment time. Methods Of the 107 patients with cervical cancer,37 received 3D conformal radiation therapy(3D-CRT),26 received conventional IMRT and 44 underwent helical tomotherapy(HT).After external irradiation at 40Gy for 4 weeks,patients in 3D-CRT group received loading brachytherapy,once a week,for 9-10 weeks.Patients in IMRT and HT groups received loading brachytherapy 3 weeks after external irradiation,twice a week,for 6-7 weeks. Results The incidence of grade 1 acute side effects in bladder and rectum of 3 groups was 56.76%,23.08% and 18.18%,respectively(χ²=6.13,P<0.05) and 86.49%,53.85% and 29.55%,respectively(χ²=10.37,P<0.01). Conclusion IMRT and HT can shorten 2-3 weeks of radical cervical cancer treatment time with a low incidence of side effects.

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