盆腔体外联合腔内放射治疗宫颈癌72例临床疗效分析

Clinical analysis on 72 cervical cancer patients with external radiotherapy combined brachytherapy

关键词:  宫颈癌  外照射  后装腔内放疗

Key words:  cervical cancer  external radiotherapy  brachytherapy

摘要:

［目的］研究盆腔体外联合腔内放射治疗宫颈癌的临床疗效、不良反应及预后影响因素。［方法］72例初治Ⅰ～Ⅳ期宫颈癌患者接受6－MVX线全盆前后对穿照射4000～5000 cGy，体外放疗3～4次/周，每次180～200 cGy；宫腔内放疗3000～4000 cGy，阴道腔内放疗3000～4500 cGy，1～2次/周，300～700 cGy/次，宫腔与阴道的腔内治疗交替进行。［结果］盆腔体外联合腔内放射治疗宫颈癌的近期有效率是98.6%，5年总生存率为54.1%，其中Ⅱ期5年生存率为75.0%，Ⅲ期5年生存率为41.4%，影响宫颈癌近期疗效的主要因素是肿瘤的大小、肿瘤的病理类型、大小、分期及近期疗效是影响宫颈癌预后的因素。常见的不良反应为腹痛、腹泻、尿频、尿急、排尿痛及骨髓抑制。［结论］盆腔体外联合腔内放射治疗宫颈癌能提高肿瘤的局部控制率，但不能有效地控制全身转移。作者认为放化同步治疗是未来治疗子宫颈癌的最佳方法。

Abstract:

［Objective］ To evaluate the efficiency and complications and prognosis in 72 cervical cancer patients receiving external radiotherapy combined with brachytherapy. ［Methods］ From June 1999 To December 2002, 72 patients diagnosed with uterine cervical cancer received initial treatment 6 - MVX basin-wide line before and after exposure to 4000~5000 cGy, extra-radiotherapy 3~4 times per week with 180~200 cGy, intrauterine radiotherapy with 3000 to 4000 cGy, intra-vaginal cavity radiotherapy with 3000~4500 cGy and 1~2 times per week. Intra-uterine and intra-vaginal cavity was turned over each other for treatment. ［Results］ The immediate efficiency was 98.6% and total 5 year survival rates were 54.1％. Stage Ⅱ and stage Ⅲ were 75.0％and 41.4％. Tumor size was the most important factor to influence the immediate efficiency. Clinical stage, tumor size, pathologic type and recent effects can influence the prognosis of cervical cancer. The adverse effects were abdominal pain, diarrhea, frequency of micturition, urgency of urination, urodynia and complication of bone marrow. ［Conclusions］ The external radiotherapy and brachytherapy can attenuate the tumor growth locally and reduce tumor recurrence, but the treatments cannot efficiently prevent cancer transfer in the body. Concurrent chemo-radio therapy might be the mainstream approach of cervical cancer.