摘要:
目的 分析三维腔内放疗用于宫颈癌ⅠB1期、ⅡA1期病灶直径3~4 cm患者的应用效果,探讨其临床意义.方法 选取保定市第一中心医院放疗科2014年1月~2016年6月收治的早期宫颈癌(Ⅰ B1期和ⅡA1期)并行腹腔镜下宫颈癌根治术者为研究对象,按随机数字表法分为两组,各32例.观察组术前采用CT引导下三维腔内放疗,继行手术治疗,对照组直接采用宫颈癌根治术.记录两组一般情况和手术时间、出血量、术后病理、住院日、并发症以及辅助放化疗情况等治疗相关指标.结果 两组平均年龄、体重指数、宫颈病灶最大直径、FIGO临床分期和病理类型构成比差异无统计学意义(P>0.05).观察组术中出血量[(197.0±85.4) mL]少于对照组[(253.8±112.1)mL],术后病理中宫颈病灶直径[(1.9±0.5)cm]小于对照组[(3.6±0.7)cm],术后辅助放化疗者(9例)少于对照组(17例),差异均有统计学意义(P<0.05);两组平均手术时间[(169.2±49.3)min比(195.7±70.1)min]、平均住院日[(16.4±3.9)d比(15.9±4.5)d]和并发症发生率[7例(21.9%)比11例(34.4%)]差异均无统计学意义(P> 0.05).结论 三维腔内放疗能够有效缩小宫颈病灶体积,有效减少术中出血,有利于手术实施;同时能够减少手术病理中影响预后的高危因素,具有重要意义.%Objective To analyze the clinical efficacy of three-dimensional intracavitary brachytherapy in the treatment of cervical cancer with stage Ⅰ B1 and Ⅱ A1 (3-4 cm in diameter).Methods The cases of early cervical cancer (stage Ⅰ B1 and stage Ⅱ A1) treated in Baoding First Central Hospital from January 2014 to June 2016 were selected,who underwent laparoscopic radical hysterectomy.The patients were randomly divided into two groups,with 32 patients in each group,the observation group received three dimensional intracavitary radiotherapy guided by CT,followed by surgical treatment,while the control group was treated with radical hysterectomy.The general situation and treatment related indicators were observed and recorded.Results There was no significant difference between the two groups in mean age,body mass index,maximum diameter of cervical lesion,FIGO clinical stage and pathological type (P > 0.05).The blood loss in the observation group [(197.0±85.4) mL] was less than that in the control group [(253.8±112.1) mL],the diameter of the cervical lesion in the postoperative pathology [(1.9±0.5) cm] was smaller than that in the control group [(3.6± 0.7) cm],and the cases of postoperative adjuvant radiotherapy and chemotherapy (9 cases) were less than the control group (17 cases),the differences were statistically significant (P < 0.05).The average operation time [(169.2±49.3) min vs.(195.7±70.1) min],average length of stay [(16.4±3.9) d vs.(15.9±4.5) d] and complication rate [7 cases (21.9%) vs.11 cases (34.4%)] between the two groups were not statistically significant (P > 0.05).Conclusion Three dimensional intracavitary radiotherapy can effectively reduce the volume of cervical lesions and be beneficial to the implementation of surgery.Meanwhile,it can reduce the risk factors of prognosis.