山西某三甲医院三维适形放疗与调强放疗治疗宫颈癌患者的临床疗效比较

发布时间：2018-03-24 09:55

本文选题：宫颈癌　切入点：放射治疗　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:山西省是我国宫颈癌高发的地区之一,本研究将470例宫颈癌患者作为研究对象,比较不同放射方式(三维适形放疗与调强放疗)治疗后对患者临床疗效影响的差异。方法:搜集201205-201505期间在山西省肿瘤医院就诊的宫颈癌的470份患者病例,分析三维适形放疗和调强放疗治疗宫颈癌患者的临床表现。应用SPSS17.0软件进行统计学分析,统计方法包括t检验,χ2检验,来分析两组在血液毒性反应、生存与复发和放射性副反应等方面的差异。结果:在三维适性放疗组中,出现1级毒性反应71例(31.4%),2级毒性反应53例(23.5%),3级毒性反应45例(19.9%);在调强放疗组中,出现1级毒性反应78例(31.9%),2级毒性反应62例(25.4%),3级毒性反应29例(11.9%);仅3级毒性反应两组具有差异性,而两组都无4级毒性反应的发生。同时,血红蛋白(Hb)和红细胞(RBC)调强放疗组显著高于三维适性放疗组,而血小板(PLT)和白细胞(WBC)处于同一水平。三维适形放射治疗组复发63例(27.9%),44例为局部盆腔复发,19例为远处复发;调强放射治疗组复发42例(17.2%),29例为局部盆腔复发,13例为远处复发,两组之间统计学均无显著性差异(P0.05)。三维适形放射治疗组放射性直肠炎发生率是20.8%,显著高于调强放射治疗组的发生率(P0.05),其中间歇性便急反应症状明显,差异显著。结论:1)三维适形放射治疗组和调强放射治疗组都会产生血液毒性反应,降低血小板含量和减少白细胞数量。2)直肠反应发生率三维适形放射治疗组显著高于调强放射治疗组。3)三维适形放射治疗组间歇性便急的直肠炎反应的发生显著高于调强放射治疗组,而其它反应症状两组均存在发生。
[Abstract]:Objective: Shanxi Province is one of the areas with high incidence of cervical cancer in China. In this study, 470 patients with cervical cancer were studied. To compare the effects of three dimensional conformal radiotherapy (3D conformal radiotherapy) and intensity modulated radiotherapy (IMRT) on the clinical efficacy of patients with cervical cancer. Methods: 470 cases of cervical cancer in Shanxi Provincial Cancer Hospital from 201205-201505 were collected. Three dimensional conformal radiotherapy and intensity modulated radiotherapy were used to analyze the clinical manifestations of cervical cancer patients. The statistical methods including t test and 蠂 2 test were used to analyze the blood toxicity of the two groups. Results: there were 71 cases of grade 1 toxic reaction and 53 cases of grade 2 toxic reaction in the three dimensional adaptive radiotherapy group. There were 45 cases of grade 3 toxic reaction in the intensity modulated radiotherapy group, while in the intensity modulated radiotherapy group, there were 45 cases of the grade 3 toxic reaction. There were 78 cases of grade 1 toxic reaction and 62 cases of grade 2 toxic reaction. There were 29 cases of grade 3 toxicity reaction in 29 cases, only grade 3 toxicity reaction had difference between the two groups, but there was no grade 4 toxic reaction in both groups. At the same time, there was no grade 4 toxic reaction in both groups. Hemoglobin HB) and RBC were significantly higher in the intensity modulated radiotherapy group than in the three dimensional conformal radiotherapy group, but PLT and WBCwere at the same level. In the 3D conformal radiotherapy group, there were 63 recurrence cases (27.9C) and 44 cases local pelvic recurrence (19 cases were distant recurrence). In the intensity modulated radiotherapy group, there were 42 cases of recurrence and 29 cases of local pelvic recurrence. 13 cases were distant recurrence. There was no significant difference between the two groups (P 0.05). The incidence of radiation proctitis in the three dimensional conformal radiotherapy group was 20. 8, which was significantly higher than that in the intensity modulated radiation therapy group (P 0. 05). Conclusion: Three-dimensional conformal radiation therapy group and intensity modulated radiation group can produce blood toxicity reaction. Reduction of platelet content and leukocyte count. 2) incidence of rectal reaction in 3D conformal radiotherapy group was significantly higher than that in intensity modulated radiotherapy group. 3) intermittent colitis response was significantly higher in 3D conformal radiotherapy group. In the intensity modulated radiotherapy group, Other reaction symptoms occurred in both groups.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.55;R737.33

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