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[腔内治疗在宫颈癌中的价值与重要性]

[Value and importance of intracavitary therapy in cervix carcinoma].

作者信息

Frischkorn R

出版信息

Strahlenther Onkol. 1986 Jun;162(6):361-7.

PMID:3738737
Abstract

The guiding topic of this report was "the value and importance of intracavitary therapy in uterine cervix carcinoma". This implies first of all the task to assess the importance of contact therapy within the scope of all therapeutic measures taken in case of uterine cervix carcinoma. Furthermore it was necessary to compare the importance of the different methods of contact therapy: conventional radium therapy as well as low dose rate and high dose rate afterloading techniques. As to surgical intervention, it is clear that only favorable stages can be taken into consideration for this treatment. It is shown by means of data taken from the Annual Report, Vol. 18, that a considerable number of patients with uterine cervix carcinoma I are irradiated even in hospitals whose field of activity lies preponderantly in surgery, and that by far most of the patients cured from uterine cervix cancer owe their recovery to contact therapy. The consideration of contact therapy methods shows clearly that radium should no longer be used in clinical practice. Psychological doubts often hinder the decision if long-term or short-term afterloading therapy is to be applied. It is therefore shown that the very different forms of radium therapy with their chronological and spatial dose distribution were due to the characteristics of radium (e.g. little specific activity) or to other compelling features and that they were not based on radiobiological aspects. The radium dose values obtained by empirical research and the resulting spatial and chronological dose distribution are therefore not imperative. So it is not inevitable to choose the low dose rate afterloading method. On the contrary, the high dose rate technique with an adequate fractionation is very probably the method of choice. To sum up it can be said that contact therapy is still the most important therapeutic method in uterine cervix cancer.

摘要

本报告的指导主题是“腔内治疗在子宫颈癌中的价值和重要性”。这首先意味着有一项任务,即在子宫颈癌所采取的所有治疗措施范围内评估接触治疗的重要性。此外,有必要比较不同接触治疗方法的重要性:传统镭疗以及低剂量率和高剂量率后装技术。至于手术干预,显然只有病情有利的阶段才会考虑采用这种治疗方法。从第18卷年度报告中获取的数据表明,即使在主要从事手术的医院,也有相当数量的子宫颈癌I期患者接受了放疗,而且到目前为止,大多数子宫颈癌治愈患者的康复都归功于接触治疗。对接触治疗方法的考量清楚地表明,镭在临床实践中不应再被使用。在决定采用长期还是短期后装治疗时,心理上的疑虑常常会造成阻碍。因此可以看出,镭疗的各种不同形式及其时间和空间剂量分布是由于镭的特性(例如比活度低)或其他强制因素造成的,并非基于放射生物学方面。因此,通过实证研究获得的镭剂量值以及由此产生的空间和时间剂量分布并非是必须遵循的。所以,选择低剂量率后装方法并非必然。相反,采用适当分次的高剂量率技术很可能是首选方法。总而言之,可以说接触治疗仍然是子宫颈癌最重要的治疗方法。

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