宫颈癌_____](期刊论文)

盆腔外照加铱源腔内治疗宫颈癌135例临床分析

http://www.100md.com 《实用医技杂志》 2006年第2期

宫颈癌,,],宫颈癌；放射治疗；192Ir；放射性直肠炎；放射性膀胱炎,1材料和方法,2结果,3讨论,参考文献：

     [摘要] 目的：研究全盆腔外照后加192Ir腔内治疗宫颈癌的疗效及对直肠膀胱的影响。方法：对135例首治宫颈癌患者采用先全盆腔外照3 000 cGy~4 000 cGy；然后行中央铅挡外照射1 600 cGy~2 000 cGy，并同时行腔内放疗：A点剂量500 cGy/次~700 cGy/次、2次/周，A点总剂量为2 800 cGy~3 600 cGy。结果：近期有效率为100%；1 a、3 a生存率分别为94.82%及85.53%；1 a及3 a放射性直肠炎发生率为8.15%、9.86%；1 a及3 a放射性膀胱炎发生率为2.96%、4.23%。结论：先全盆腔外照一定剂量后再加192Ir放射源腔内治疗宫颈癌具有很好的疗效。治疗方法得当可以减少放射性直肠炎及膀胱炎的发生率。

    [关键词] 宫颈癌；放射治疗；192Ir；放射性直肠炎；放射性膀胱炎

    Trial of External Radiotherapy and192Ir Brachytherapy in Cervical Cancer

    DING Yunxia，WANG Yonggang,LIU Yue，et al

    (Kunming Ceneral Hospital of Chengdu Military Region of the PLA，Kunming，Yunan 650032，China)

    Abstract：Objective To evaluate the efficacy and complications of rectum and bladder,using external radiotherapy and brachytherapy for patiens with cervical carcinoma.Methods From February 1998 to December 2003，135 patients diagnosed with uterine cervical cancer (5Ⅰb，28Ⅱa，59Ⅱb，30Ⅲa，9Ⅲb,4Ⅳa),who underwent external radiation with between five and seven courses of highdose rate intracavitary brachytherapy(HDRICB) and a minimum of 1 year of followup were analyzed.Treatment consisted of irradiation of whole pelvis with 30 Gy~40 Gy consisting of 1522 fractions,with the dose boosted to 46 Gy~60 Gy(with central shielding) for bilateral parametrial disease.HDRICB was performed using and192Ir remote after loading technique at 1/2week intervals.The standard prescribed dose for each course of HDRICB was 5 Gy～7 Gy to point A. Total prescribed point A doses(external beam radiotherapy+ HDRICB ) ranged from 60 to 80 Gy.Results 1year and 3year survival rates were 94.82% and 85.53%. The rates of 1year and 3year complication for the rectum were 8.15% and 9.86%.The rates of 1year and 3year complication for the bladder were 2.96% and 4.23%.Conclusions The external radiotherapy and 192Ir brachytherapy for patiens with cervical carcinoma could achieve satisfactory disease control.This irradiation is optimized may decrease the incidence of rectal and bladder complications. ......

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