Yu Kewen, Zhou Liping
Department of gynecology, Ningbo Women and Children's Hospital, Ningbo, China.
Department of gynecology, Zhuji People's Hospital of Zhejiang Province, Zhuji, China.
Front Surg. 2022 May 23;9:906117. doi: 10.3389/fsurg.2022.906117. eCollection 2022.
To explore the efficacy, safety, and prognostic factors of intensity modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) combined with intracavitary posterior radiotherapy for medium-term and advanced cervical cancer.
Retrospectively analyze the clinical data of 104 patients with medium-term and advanced cervical cancer who were treated in the radiotherapy department of our hospital from September 2015 to March 2017. According to the different radiotherapy techniques, they were divided into the IMRT combined with intracavitary posterior radiotherapy group ( = 52) and the 3D-CRT combined with intracavitary posterior radiotherapy group ( = 52). Observe and compare the short-term efficacy, occurrence of adverse reactions and overall survival rate of the two groups. The clinicopathological characteristics of the survival group and the death group were compared, and univariate analysis and multiple logistic regression models were used to analyze the relationship between the clinicopathological characteristics and the patient's prognosis.
The total effective rate of IMRT combined with intracavitary posterior radiotherapy group was 96.15%, which was higher than that of 3D-CRT combined with intracavitary posterior radiotherapy group (88.46%), but the difference was not statistically significant (> 0.05). The incidence of digestive system injury, thrombocytopenia, and radiation proctitis in the IMRT combined intracavitary posterior radiotherapy group was lower than that of the 3D-CRT combined intracavitary posterior radiotherapy group, and the differences were statistically significant (< 0.05). The prognosis and survival of the two groups of patients were similar, and the difference was not statistically significant (> 0.05). Pathological classification, clinical stage, and lymph node metastasis are independent influencing factors of 3-year prognosis in patients with medium-term and advanced cervical cancer (< 0.05).
IMRT combined with intracavitary posterior radiotherapy is equivalent to 3D-CRT combined with intracavitary posterior radiotherapy, but it can reduce the incidence of adverse reactions in patients with medium-term and advanced cervical cancer, and has higher safety. Pathological typing, clinical staging, Lymph node metastasis were independent factor affecting the prognosis of patients. In clinical treatment, IMRT combined with intracavitary posterior radiotherapy is more recommended as a treatment plan for patients with medium-term and advanced cervical cancer.
探讨调强适形放射治疗（IMRT）与三维适形放射治疗（3D-CRT）联合腔内后装放疗治疗中晚期宫颈癌的疗效、安全性及预后因素。
回顾性分析2015年9月至2017年3月在我院放疗科治疗的104例中晚期宫颈癌患者的临床资料。根据放疗技术不同，将其分为IMRT联合腔内后装放疗组（n = 52）和3D-CRT联合腔内后装放疗组（n = 52）。观察并比较两组的近期疗效、不良反应发生情况及总生存率。比较生存组与死亡组的临床病理特征，采用单因素分析及多因素logistic回归模型分析临床病理特征与患者预后的关系。
IMRT联合腔内后装放疗组的总有效率为96.15%，高于3D-CRT联合腔内后装放疗组（88.46%），但差异无统计学意义（P>0.05）。IMRT联合腔内后装放疗组消化系统损伤、血小板减少及放射性直肠炎的发生率低于3D-CRT联合腔内后装放疗组，差异有统计学意义（P<0.05）。两组患者的预后及生存率相似，差异无统计学意义（P>0.05）。病理分级、临床分期及淋巴结转移是中晚期宫颈癌患者3年预后的独立影响因素（P<0.05）。
IMRT联合腔内后装放疗与3D-CRT联合腔内后装放疗疗效相当，但可降低中晚期宫颈癌患者不良反应的发生率，安全性更高。病理分型、临床分期、淋巴结转移是影响患者预后的独立因素。在临床治疗中，更推荐IMRT联合腔内后装放疗作为中晚期宫颈癌患者的治疗方案。
