同步放化疗联合伽马刀治疗伴盆腔淋巴结转移宫颈癌的临床研究

发布时间：2019-07-06 13:58

【摘要】：目的:评价同步放化疗联合伽马刀治疗伴盆腔淋巴结转移宫颈癌的疗效及不良反应。方法:回顾性分析42例内蒙古医科大学附属医院说明放疗科同步放化疗治疗伴淋巴结转移宫颈癌患者。外照射三维适形调强放疗(IMRT)的盆腔剂量PTV为50.4 Gy/28 F,淋巴结剂量为PGTVnd 59.92 Gy/28 F,联合腔内照射剂量为36 Gy/6 F。同步化疗方案为顺铂40 mg/m2/周,静脉滴注。同步放化疗结束后3个月复查,对淋巴结仍有残存患者行局部伽马刀治疗,剂量为10~15 Gy/3~4 F。结果:3个月近期疗效为83.3%(35/42)。6、9、12个月局部控制率分别为88.1%(37/42)、83.3%(35/42)、80.0%(32/40)。1、2年生存率分别为77.5%(31/40)、70.0%(28/40)。主要不良反应包括放射性小肠炎[11.9%(5/42)]、直肠炎[38.1%(16/42)]、膀胱炎[7.1%(3/42)]、消化道反应[90.5%(38/42)]与粒细胞减少[85.7%(36/42)],其中绝大多数为1~2级反应。结论:同步放化疗联合伽马刀治疗伴盆腔淋巴结转移宫颈癌疗效较好,不良反应在可接受范围之内,是临床可行的治疗手段。
[Abstract]:Objective: to evaluate the efficacy and side effects of synchronous radiotherapy and chemotherapy combined with gamma knife in the treatment of cervical cancer with pelvic lymph node metastasis. Methods: 42 patients with cervical cancer with lymph node metastasis were treated with radiotherapy and chemotherapy in affiliated Hospital of Inner Mongolia Medical University. The pelvic dose PTV was 50.4 Gy/28 F, the lymph node dose was PGTVnd 59.92 Gy/28 F, and the combined intracavitary irradiation dose was 36 Gy/6 F. The synchronous chemotherapy regimen was DDP for 40 mg/m2/ weeks, intravenous drip. Three months after simultaneous radiotherapy and chemotherapy, patients with residual lymph nodes were treated with local gamma knife at a dose of 10 鈮，

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