三维适形放射治疗联合紫杉醇每周方案化疗治疗中晚期宫颈癌疗效观察

摘要

Objective:To observe the curative efficacy and side effects in middle and advanced-stage uterine cer-vix cancer patients treated with three dimensional conformal radiation therapy (3D -CRT)with weekly paclitaxel chemotherapy.Methods:All 100 advanced cervical cancer patients with Ⅱb -Ⅲb stages were treated.The control group of 40 patients before and after two whole pelvic irradiation field for wear.The treatment group of 60 patients syn-chronization paclitaxel vacuum pad fixed,CT simulator positioning,outline the tumor target(GTV),clinical target vol-ume(CTV)and planning target volume(PTV),verification of radiotherapy plans three dimensional conformal radio-therapy.Radiation therapy for all patients using single-agent chemotherapy dose 75mg/m2,once a week.Results:For 60 cases of cervical cancer patients total efficiency(CR+PR)was 85.00%(51/60),and the control group was (CR+PR)57.50%(23/40).There was a significant difference(P<0.05).The 1,2,3 -year survival rates of treated group were 100%(60/60),100%(60/60),96.67%(58/60),however,the patients of control group were 100%(40/40),90.0%(36/40)and 85.0%(34/40),respectively.But the difference was not statistically significant be-tween treatment group and the control group(P>0.05 ).The reaction of radiotherapy treatment group were grade Ⅰ-Ⅱ,no Ⅳ adverse reactions occur in treatment group.Conclusion:Compared to ordinary pelvic radiotherapy,3D-CRT combined with weekly paclitaxel chemotherapy in the treatment of advanced cervical cancer have better local control rate,mild adverse reactions,and the operation is easy.%目的：观察三维适形放射治疗联合紫杉醇每周方案化疗治疗不能手术的中晚期宫颈癌临床疗效和毒副反应。方法：选择临床确诊为Ⅱb -Ⅲb 期中晚期宫颈癌患者100例。对照组40例进行全盆腔前后两野对穿照射。治疗组60例采用真空垫固定、CT模拟机定位，勾画肿瘤靶区（GTV）、临床靶区（CTV）和计划靶区（PTV），验证放疗计划进行三维适形放疗。所有患者放射治疗期间同步紫杉醇单药化疗，药物剂量75 mg/m2，每周一次。观察同步放化疗的近远期疗效和毒副反应。结果：治疗组60例宫颈癌患者总有效率（CR＋PR）为85．00％（51/60），与对照组有效率57．50％（23/40）比较，有显著性差异（P＜0．05）。治疗组患者1、2、3年生存率分别为100％（60/60）、100％（60/60）、96．67％（58/60），对照组患者1、2、3年生存率分别为100％（40/40）、90．0％（36/40）和85．0％（34/40），二者差异无统计学意义（均P＞0．05）。治疗组早晚期放疗反应主要为Ⅰ-Ⅱ级，无Ⅳ级不良反应发生。结论：与盆腔普通放疗相比较，三维适形放射治疗联合紫杉醇每周方案化疗治疗中晚期宫颈癌有较高的有效率，不良反应轻，患者易耐受，且操作易行。