目的 总结Ⅰb和Ⅱ期宫颈癌术后调强放疗的疗效。方法 回顾分析2008-01至2012-02收治的83例手术+术后放疗的宫颈癌临床病例资料,放疗剂量50 Gy/25次/5周,所有病例术后均接受2～4周期以铂类为基础的化疗,分析指标主要有生存率、无瘤生存率、局部控制率及不良反应等。结果 所有患者均顺利完成治疗,随访率为100％。全组3年总生存率为89.2％,无瘤生存率为83.1％,盆腔局部控制率为85.5％。腺癌和鳞癌的总生存率分别为50％和91％(χ2=9.65,P=0.002)。肠道反应1、2级发生率为10.34％,泌尿系反应1、2级发生率为10.34％,外周血白细胞计数下降1、2级发生率为58.62％,无4级不良反应。结论 Ⅰb和Ⅱ期宫颈癌术后具有不良预后因素者行调强放疗具有较高的生存率和局部控制率,不良反应可耐受。
Abstract
Objective To analyze the efficacy and treatment related toxicities for patients with Ⅰb and Ⅱ stage cervical cancer treated by Intensity Modulated Radiation Therapy (IMRT).Methods From January 2008 to February 2012,83 patients with stageⅠb-Ⅱ postoperative cervical cancer were retrospectively analyzed.The clinical target volume received a dose of 50 Gy/25 fractions in all patients.All patients were treated by IMRT and cisplatin-based chemotherapy for 2-4 cycles.Results Treatment was completed successfully in all patients. The follow-up rate was 100%. In all patients, the 3-year overall survival (OS) rate was 89.2％, with disease-free survival (DFS) rate of 83.1％ and pelevic local control (LC) rate of 85.5％. The 3-year OS rates were 50％ and 91％ for patients with adenocarcinoma and squamous carcinoma(χ2=9.65,P=0.002). The incidences of grade 1-2 rectal toxicity , urinary toxicity and myelosuppression were 10.34％,10.34％ and 58.62％. There were no grade 4 toxicities.Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo IMRT can achieve high overall survival rates,local control rates and tolerable toxicities.
关键词
宫颈肿瘤/放化疗法 /
调强放射治疗 /
预后
Key words
cervical neoplasms/radiochemotherapy /
intensity modulated radiation therapy /
prognosis
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