【摘要】 目的观察同步加量调强放射治疗在宫颈癌并盆腔淋巴结转移患者中的疗效及毒副反应.方法对盆腔淋巴结转移的局部晚期宫颈癌患者,行放化疗同步治疗,放疗为外照射加后装腔内照射,后装治疗A点DT30 Gy/5f;外照射采用同步加量调强放射治疗,靶区包括GTVnd(阳性淋巴结)及CTV(包括子宫、宫颈、部分阴道及其旁组织,和盆腔淋巴结引流区).两靶区的总剂量及分割剂量分别为PGTVnd:62.4 Gy/26 f,2.4 Gy/f;PTV:46.8 Gy/26f,1.8 Gy/f.结果治疗近期疗效评价:CR(44/49)89.8%,PR(4/49)8.2%,SD(1/49)2%.Ⅲ度骨髓抑制发生率(9/49)18.4%,重度肠道反应发生率(3/49)6%.结论同步加量调强放射治疗在宫颈癌并盆腔淋巴结转移患者中的近期疗效好,毒副反应可耐受.更多还原

【Abstract】 Objective This study was aimed to evaluate the efficacy and toxicity of simultaneous modulated accelerated radiotherapy(SMART) for advanced cervical carcinoma. Methods From March 2012 to July 2013,49 patients with advanced cervical carcinoma received accelerated chemoradiation with concurrent cisplatin. Step and shoot IMRT with simultaneous integrated boost(SIB) was delivered to patients. The doses for intensity-modulated radiotherapy with simultaneous integrated boost were 62.4 Gy/26 f, 2.4 Gy/f to the planning target volume(GTVnd),and 46.8 Gy/26 f, 1.8 Gy/f to the gross disease and pelvic nodes(CTV),respectively. Results All the patients completed chemoradiotherapy as prescribed. The CR,PR and SD of patients were 89.8%, 8.2% and2%,respectively. Grade 3 myelosuppression and acute radiation enteritis occurred in 9 patients(18.4%) and 3patients(6%),respectively. Conclusion The results showed that SMART exhibited good short-term effect for cervical carcinoma, and its acute toxicity was tolerable.更多还原