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目的 研究1 92 Ir高剂量率腔内加体外放射治疗宫颈癌的疗效和放射反应。方法 1 1 8例宫颈癌患者采用1 92 Ir高剂量率腔内加体外放射治疗 ,开始体外全盆腔照射 ,5次 /周 ,2Gy/次 ,盆腔平面中心剂量 2 6～ 40Gy ,2 .5～ 4 .0周完成 ;然后中间挡铅 ,4个野照射 ,4次 /周 ,2Gy/次 ,宫旁剂量 2 0～ 2 5Gy ;同时腔内治疗 ,1次 /周 ,6Gy/次 ,剂量为 36～ 42Gy。结果 全组 3、5年生存率分别为 83 .1 %和 72 .0 % ,Ⅱ、Ⅲ期 5年生存率分别为 80 .6 %和 58.7% (P >0 .0 5)。早期放射性直肠反应发生率为1 3 .6 % ,膀胱反应发生率为 5 .9% ;晚期放射性直肠炎发生率为 1 5 .3 % ,膀胱炎为 4 .2 % ,直肠阴道瘘为0 .9%。结论 1 92 Ir高剂量率腔内加体外照射治疗宫颈癌疗效肯定 ,应用方便 ,副作用少。
Objective To investigate the efficacy and radiation response of 1 92 Ir high dose rate intracavitary plus external beam radiotherapy for cervical cancer. METHODS: One hundred and eighty cervical cancer patients were treated with 1 92 Ir high dose rate intracavitary plus external beam radiation. Total pelvic irradiation was started in vitro, 5 times / week, 2Gy / time, pelvic plane center dose 26 ~ 40Gy, 2.5 ~ 4 weeks, 4 weeks / week, 2Gy / time, intrauterine dose of 20 ~ 25 Gy; while intracavitary treatment, once / week, 6Gy / dose of 36 ~ 42Gy. Results The 3 and 5-year overall survival rates were 83.1% and 72.0% respectively. The 5-year survival rates of stage II and III were 80.6% and 58.7%, respectively (P 0. 05). The incidence of early radioactive rectal reaction was 13.6%, the incidence of bladder reaction was 5.9%, the incidence of advanced radiation proctitis was 15.3%, cystitis was 4.2% and rectovaginal fistula was 0. 9%. Conclusion 1 92 Ir high dose rate intracavitary plus external irradiation for the treatment of cervical cancer is positive, easy to use, with few side effects.