高剂量率192Ir后装腔内加外照射治疗宫颈癌的远期疗效分析

摘要

Objective To analyze retrosrectively long- term effect of cervix carcinona treated by HDR 192Ir afterloading intracavitory radiotherapy combined with external irradiation. Methods From Mar 1993 to Dec 1994, 128 cases of cervix cancer(age from 29 years to 80 years) were treated with combination of external irradiation and HDR 192Ir afterloading intracavitory radiotherapy. 47 cases were stage Ⅱ and 81 were stage Ⅲ. The dose of external radiotherapy was 40 Gy or 50 Gy and afterloading irradiation was given in 6 or 7 fractions of 8 Gy. Results The overall local tumor control was 94.5％, the 1,3,5 year survival rates were 91.61％, 81.89％and 67.36％. The 1,3,5 year survival rates of stage Ⅱ and stage Ⅲ cases were 95.28％ and 89. 47％, 87.19％ and 79.50％, 72.76％ and 64.95％ (P＞0.05). The rate of severe complications was 7.03％ (9/128). Conclusion HDR 192Ir afterloading intracavitory radiotherapy combined with external irradiation for cervix carcinoma is effective and less side effects.%目的分析高剂量率192Ir后装腔内加外照射治疗宫颈癌的远期疗效及并发症。方法对128例Ⅱ、Ⅲ期放疗后宫颈癌进行了回顾分析。其中Ⅱ期47例，Ⅲ期81例。全盆腔外照射Dr20Gy/10次，全盆中间挡铅4cmDr20Gy～30Gy/10次～15次；后装A点剂量48Gy～56Gy/6次～7次。结果 1、3、5年生存率分别为91.61％、81.8％和67.36％；Ⅱ、Ⅲ期1、3、5年生存率无统计学差异(P＞0.05)；远期严重并发症的发生率7.03％(9/128)。结论高剂量率192Ir后装腔内加外照射治疗宫颈癌疗效肯定，并发症少。盆腔局部复发仍是放疗失败的主要原因。