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目的比较宫颈癌患者同步放化疗后三维适形放疗与调强放疗的血液毒性(HT)。方法将符合纳入标准的180例宫颈癌患者分为2组:3DCRT组(89例)和IMRT组(91例)。检测化疗期间及放疗2年内血红蛋白、白细胞、中性粒细胞和血小板计数的最低水平。结果 2级或以上急性贫血、白细胞减少、粒细胞减少症和血小板减少症3DCRT组分别为2%、42%、11%,0;IMRT组分别为26%,53%,24%,和4%。2级或以上慢性贫血、白细胞减少、粒细胞减少症和血小板减少症在3DCRT组分别为12%、12%、6%和12%;IMRT组分别为0、9%、4%、和0。LS-V30,40;IL-V10,20,30,40;LP-V10,20,40;P-V10,20,30,40;WP-V10,20,30,40;与3DCRT组相比,IMRT组显著减少。结论与三维适形放疗,IMRT可减少照射的骨髓体积,然而在急性和慢性HT方面,两种技术比较无差异。
Objective To compare the hematotoxicity (HT) of three-dimensional conformal radiotherapy and intensity-modulated radiotherapy in patients with cervical cancer after concurrent chemoradiotherapy. Methods 180 patients with cervical cancer who met the inclusion criteria were divided into two groups: 3DCRT group (n = 89) and IMRT group (n = 91). The lowest level of hemoglobin, leucocyte, neutrophil and platelet counts during chemotherapy and 2 years of radiotherapy was detected. Results The rates of acute renal failure, leukopenia, neutropenia and thrombocytopenia were 2%, 42%, 11%, 0% in group 2 and 26%, 53%, 24% and 4% . Grade 2 or higher chronic anemia, leukopenia, neutropenia and thrombocytopenia were 12%, 12%, 6% and 12% in the 3DCRT group, respectively; 0,9%, 4% and 0% in the IMRT group, respectively. LS-V30,40; IL-V10,20,30,40; LP-V10,20,40; P-V10,20,30,40; WP-V10,20,30,40; IMRT group significantly reduced. Conclusion IMRT can reduce the volume of irradiated bone marrow with three-dimensional conformal radiotherapy, however, there is no difference between the two techniques in acute and chronic HT.