高危宫颈癌术后辅助调强同期放化疗的探讨

摘要

Objective To study the treatment efficacy of intensity modulated radiotherapy(IMRT) instead of conventional radio-therapy,combined with Paclitaxel and Cisplatin in postoperative high-risk cervical cancer patients. Methods 60 cases of Ib-IIa cervical cancer patients were randomly selected and divided into 2 groups,both treatment with Paclitaxel and Cisplatin,and com-bined with intensity modulated radiotherapy to study group,but with conventional radiotherapy to control group. To analyze the ef-ficacy and toxicity of the two groups were compared. Results (1) Comparing with the control group,2 year recurrence rate and distant metastasis rate were significantly lower in study group. The differences of above two indicators in the two groups was statis-tically significant (P<0.05). However,the 2 year survival rate wasn’t statistically significant (P>0.05) in the two group. (2) Acute toxicity in gastrointestinal tract,urinary tract and hematopoietic system were significantly reduced,and chronic intestinal toxicity reaction also decreased(P<0.05). Conclusion Comparing with the conventional radiotherapy,IMRT dose distributions and shape or boundary of target and critical organs are much closer in the 3D space,and the recurrence rate,distant metastasis rate and adverse reaction were reduced.%目的：探讨调强放疗代替传统放疗，辅以紫杉醇和顺铂治疗高危宫颈癌术后的疗效。方法随机选取Ib-IIa期宫颈癌术后患者60例，随机均分成2组，研究组辅以调强放疗，对照组辅以传统放疗，两组均加同期紫杉醇和顺铂化疗。观察对比两组的疗效和毒副反应。结果（1）研究组2年肿瘤复发率、远处转移率均显著低于对照组（P<0.05），2年生存率两组间无统计学差异（P>0.05）。（2）研究组胃肠道、泌尿和造血系统急性毒副反应减少，慢性肠道毒性反应减少（P<0.05）。结论调强放射治疗的剂量分布与靶区和重要器官的外形或边界在三维空间上更为接近，与传统放疗相比，降低了肿瘤复发率、远处转移率及毒副反应。