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[725例子宫肿瘤中钴60粒子放疗与手术治疗的结果比较]

[Results of radiotherapy with cobalt 60 beads compared to surgery in 725 uterine neoplasms].

作者信息

Fournier D, Kuttig H, Kubli F, Braun K

出版信息

Strahlentherapie. 1975 Sep;150(3):273-9.

PMID:1209670
Abstract

From 1958 to 1970, in 435 cases (60%) out of 725 carcinomas of the uterus sole radiation therapy by cobalt-60 beads was performed; in 288 cases (39.7%) surgery was done (combined with tele-cobalt-irradiation in almost all cases, 5000 to 6000 rd TD). Two cases (0.3%) received no treatment. The unfavorable selection of the irradiated women (average age 64,6 years) as against the surgically treated ones (average age 50.9 years) did allow a complete intracavitary irradiation only in 60.6% of the cases; in 39.4%, the dose had to be reduced considerably. The five-year survival amounted to: 64.4% after sole irradiation, 93.2% after operation/postirradiation in stage I; 46.9% after sole irradiation, 75.0% after operation/postirradiation in stage II; 30.8% after sole irradiation in stage III. No survivors existed in stage IV. Mortality from treatment with sole irradiation amounted to 1.8% (8/435). Radiation fistulas were observed after sole irradiation in 0.4% (1/435), after operation/postirradiation in 0.7% (2/288). As long as there is no satisfactory afterloading technique for intracavitary irradiation of the carcinoma of the uterus, an application of cobalt-60 beads seems to offer the following advantages as compared to an implant of radium filters: Shorter duration of the application, better adaptability to the cavitary lumen, diminished risk of perforation. No perforation was observed.

摘要

1958年至1970年期间,725例子宫癌患者中,435例(60%)仅采用钴-60珠进行放射治疗;288例(39.7%)接受了手术治疗(几乎所有病例均联合远距离钴照射,肿瘤剂量5000至6000拉德)。2例(0.3%)未接受治疗。与接受手术治疗的患者(平均年龄50.9岁)相比,接受放射治疗的女性患者(平均年龄64.6岁)选择不佳,仅60.6%的病例能够进行完全腔内照射;39.4%的病例剂量不得不大幅降低。五年生存率为:I期单纯放疗后为64.4%,手术/放疗后为93.2%;II期单纯放疗后为46.9%,手术/放疗后为75.0%;III期单纯放疗后为30.8%。IV期无存活病例。单纯放疗的治疗死亡率为1.8%(8/435)。单纯放疗后观察到放射性瘘管的发生率为0.4%(1/435),手术/放疗后为0.7%(2/288)。只要子宫癌腔内照射没有令人满意的后装技术,与镭滤器植入相比,应用钴-60珠似乎具有以下优点:应用时间短、对腔隙的适应性更好、穿孔风险降低。未观察到穿孔情况。

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