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超声引导下宫颈癌调强放疗的疗效、剂量及预后观察。

Observations of the effectiveness, dosage, and prognosis of intensity-modulated radiation therapy under ultrasonic guidance for cervical cancer patients.

机构信息

Physical Diagnosis Department, Beidahuang Group General Hospital, Harbin, Heilongjiang, China.

Radiotherapy Department, Beidahuang Group General Hospital, Harbin, Heilongjiang, China.

出版信息

Technol Health Care. 2024;32(6):4857-4868. doi: 10.3233/THC-231977.

Abstract

BACKGROUND

Volumetric modulated arc therapy (VMAT) guided by ultrasound is a novel radiation therapy technique that facilitates the delineation of the tumor target area under image guidance, enhancing the precision of radiation therapy and maximizing the protection of surrounding tissues.

OBJECTIVE

The objective of this paper is to investigate the effectiveness of VMAT under ultrasonic guidance for cervical cancer patients and its impact on radiotherapy dosage and prognosis.

METHODS

A retrospective analysis encompassed 128 instances of cervical cancer patients who were admitted to our medical facility between April 2019 and April 2021. The patients were categorized into an observation cohort and a control cohort, depending on variations in treatment modalities post-admission. The control group underwent conventional radiotherapy, whereas the observation group received VMAT guided by ultrasound. Clinical efficacy, average radiation dosages (in the radiotherapy target area, rectum, and bladder), radiotherapy-related toxicities during treatment, and one-year survival rates were compared between the two groups. Additionally, variances in pre- and post-treatment serum levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and carbohydrate antigen 724 (CA724) were subjected to assessment.

RESULTS

When compared to the control group (64.52%), the observation cohort's comprehensive effectiveness rate was considerably greater (80.30%). The observation group saw lower average radiation exposures and a reduction in the post-treatment concentrations of CEA, SCC-Ag, and CA724. The overall incidence of adverse effects from radiation treatment also declined. The observation group had a greater one-year survival rate (90.48%) than the control group (73.33%). When comparing the observation cohort to the control group, Kaplan-Meier survival analysis showed a significantly higher one-year survival rate (Log-Rank = 6.530, P= 0.011).

CONCLUSION

VMAT guided by ultrasound for patients with cervical cancer demonstrates promising short- and long-term treatment outcomes. It also leads to improvements in serum CEA, SCC-Ag, and CA724 levels, as well as reductions in the average radiation dosages to the radiotherapy target area, rectum, and bladder. This approach warrants attention from clinicians in clinical practice.

摘要

背景

超声引导下容积旋转调强放疗(VMAT)是一种新的放疗技术,它可以在图像引导下对肿瘤靶区进行勾画,提高放疗精度,最大限度地保护周围组织。

目的

本文旨在探讨超声引导下 VMAT 治疗宫颈癌患者的有效性及其对放疗剂量和预后的影响。

方法

回顾性分析 2019 年 4 月至 2021 年 4 月我院收治的 128 例宫颈癌患者,根据入院后治疗方式的不同分为观察组和对照组。对照组采用常规放疗,观察组采用超声引导下 VMAT 治疗。比较两组患者的临床疗效、放疗靶区、直肠和膀胱的平均照射剂量、治疗过程中的放疗相关毒性及 1 年生存率,同时比较两组患者治疗前后血清鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)和糖类抗原 724(CA724)水平的变化。

结果

观察组总有效率(80.30%)明显高于对照组(64.52%)。观察组平均照射剂量较低,治疗后 CEA、SCC-Ag 和 CA724 浓度降低,放疗相关不良反应总发生率降低,1 年生存率(90.48%)高于对照组(73.33%)。Kaplan-Meier 生存分析显示,观察组 1 年生存率高于对照组(Log-Rank=6.530,P=0.011)。

结论

超声引导下 VMAT 治疗宫颈癌具有良好的短期和长期疗效,能改善患者血清 CEA、SCC-Ag 和 CA724 水平,降低放疗靶区、直肠和膀胱的平均照射剂量,值得临床关注。

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本文引用的文献

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