全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

锎-252中子内照射结合盆腔外照射治疗宫颈癌时全挡铅与半挡铅的长期疗效观察

, PP. 1040-1043

Keywords: 宫颈癌,锎-,盆腔野,全挡铅,半挡铅

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的比较锎-252中子内照射结合外照射治疗宫颈癌时盆腔野照射全挡铅与半挡铅的治疗结果。方法分别选取2007年3月至2008年10月、2009年5-12月各115例经病理活检确诊的临床分期为Ⅱa~Ⅲb期宫颈鳞癌患者作为研究对象,按照临床分期、年龄、肿瘤直径、贫血程度进行配对研究,分为盆腔野中央全挡铅组(全挡组)和半挡铅组(半挡组)。患者采用全盆外照射中间穿插锎-252中子内照射的治疗方式。全盆外照射采用前后对穿野照射,2Gy/(次·d),4~5次/周,照射24~36Gy后,全挡组盆腔野中央挡铅4cm,而半挡组为盆腔野中央骶3以下部分挡铅4cm,继续照射至48~54Gy。中子内照射宫旁A点总剂量40~42Gy,1次/周,10~12Gy/次,共进行4次。全盆外照及锎-252腔内照射结束后,对宫旁仍有侵犯的Ⅲb期患者宫旁小野补量8~12Gy。用McNemartest的方法比较严重急性期并发症(≥G2)发生率和总体生存率、绝对无病生存率、局部控制率及严重晚期并发症(放射性直肠炎和膀胱炎)(≥G2)发生率的差异。平均随访60.2个月。结果半挡组患者急性期胃肠道反应、放射性直肠炎、放射性膀胱炎发生率略高于全挡组,但两组差异均无统计学意义(P>0.05)。半挡组患者的总体生存率、绝对无病生存率和局部控制率略高于全挡组,而盆腔淋巴结复发率和晚期并发症发生率略低于全挡组,但两组差异均无统计学意义(P>0.05)。结论宫颈癌患者根治性放疗盆腔外照射时全挡铅与半挡铅的疗效相近,建议尽可能采取半挡铅照射技术。

References

[1]  Lei X, Qian C Y, Qing Y, et al. Californium-252 brachytherapy combined with external-beam radiotherapy for cervical cancer: long-term treatment results[J]. Int J Radiat Oncol Biol Phys, 2011, 81(5): 1264-1270. [2]Lee Y Y, Park W, Huh S J, et al. Platinum-based combination chemotherapy vs. weekly cisplatin during adjuvant CCRT in early cervical cancer with pelvic LN metastasis[J]. Anticancer Res, 2013, 33(10): 4675-4681. [3]Donnelly E D, Refaat T, Gentile M, et al. Evaluation of outcomes in patients with carcinoma of the cervix treated with concurrent radiation and cisplatin versus cisplatin/5-FU compared with radiation alone[J]. Am J Clin Oncol, 2013, [Epub ahead of print]. [4]Koh W J, Moore D H. Cervical cancer[M]//Gunderson L L, Tepper J E. Clinical radiation oncology. 2nd ed. Philadephia: Churchull Livingstone, 2007: 1323-1349. [5]Perez C A, Kavanagh B D. Uterine cervix[M]//Perez C A, Brady L W, Halperin E C, et al. Principles and practice of radiation oncology. 4th ed. Philadephia: Lippincott William and willkins, 2004: 1800-1880. [6]Kidd E A, Siegel B A, Dehdashti F, et al. Clinical outcomes of definitive intensity-modulated radiation therapy with fluorodeoxyglucose-positron emission tomography simulation in patients with locally advanced cervical cancer[J]. Int J Radiat Oncol Biol Phys, 2010, 77(4): 1085-1091. [7]Cheng J C, Peng L C, Chen Y H, et al. Unique role of proximal rectal does in late rectal complications for patients with cervical cancer undergoing high-does-rate intracavitary brachtherapy[J]. Int J Radiat Oncol Biol Phys, 2003, 57(4): 1010-1018. [8]Toita T, Kakinohana Y, Ogawa K, et al. Combination external beam radiotherapy and high-dose-rate itracavitary brachytherapy for uterine cervical cancer: analysis of dose and fractionation schedule[J]. Int J Radiat Oncol Biol Phys, 2003, 56(5): 1344-1353. [9]Dose and volume specification for reporting intracavitary therapy in gynecology. ICRU report 38[R]. Washington: ICRU, 1985. [10]Maruyama Y, Feola J M, Wierzbicki J, et al. Clinical study of relative biological effectiveness for cervical carcinoma treated by 252Cf neutrons and assessed by histological tumour eradication[J]. Br J Radiol, 1990, 63(748): 270-277. [11]Lei X, Xu X C. The clinical practice of 252Cf neutron brachytherapy devices on malignant tumor in China[J]. Engineering Sciences, 2009, 7(4): 51-60. [12]单锦露, 雷新, 王东, 等. 252Cf中子腔内后装加盆腔外照射治疗子宫颈癌临床分析[J]. 中华妇产科杂志,2005, 40(4): 223-226.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133