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调强放射治疗(IMRT)和容积调强弧形治疗(VMAT)对宫颈癌患者生存获益及不良预后因素的影响。

Effects of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) on survival benefits and poor prognostic factors in patients with cervical cancer.

作者信息

Li Meili, Wu Xiuhong, Liu Xiang, Wen Meiru

机构信息

Radiation Therapy Center, Ganzhou Cancer Hospital, Ganzhou, 341000, Jiangxi, People's Republic of China.

Department of Imaging, Ganzhou Cancer Hospital, No.19 Huayuanqian Road, Shuidong Town, Zhanggong District, Ganzhou, 341000, Jiangxi, People's Republic of China.

出版信息

Biomed Eng Online. 2025 Aug 4;24(1):96. doi: 10.1186/s12938-025-01433-1.

DOI:10.1186/s12938-025-01433-1
PMID:40759943
Abstract

OBJECTIVE

This study aimed to explore the influencing factors of survival benefit and poor prognosis of cervical cancer patients under different radiotherapy modalities.

METHODS

A total of 186 patients with cervical cancer treated in our hospital from January 2022 to December 2023 were selected for the retrospective analysis. 126 patients received static intensity-modulated radiation therapy (IMRT) combined with cisplatin. Another 60 cases received volumetric modulated arc therapy (VMAT) combined with cisplatin. The occurrence of adverse reactions, overall survival rate, and recurrence rate were compared between the two groups. COX regression model was used to analyze the influencing factors of the poor prognosis.

RESULTS

There was no difference between the disease control rate (DCR) and objective remission rate (ORR), and the overall survival and recurrence rates in the two groups. The incidence of myelosuppression was much higher in the IMRT group than the VMAT group. Compared with the survival group, the percentage of lymph node metastasis (LNM) and positive margins were significantly increased in the patients in the death group. COX multifactorial analysis confirmed that LNM and positive cutting margins were independent risk factors affecting poor prognosis after radiotherapy in cervical cancer patients (P < 0.05).

CONCLUSION

Both IMRT and VMAT could achieve certain effects in the treatment of cervical cancer and had similar effects in short-term survival recurrence. However, VMAT had a lower incidence of myelosuppression. LNM and positive margins were factors influencing the poor prognosis of patients.

摘要

目的

本研究旨在探讨不同放疗方式下宫颈癌患者生存获益及预后不良的影响因素。

方法

选取2022年1月至2023年12月在我院接受治疗的186例宫颈癌患者进行回顾性分析。126例患者接受静态调强放射治疗(IMRT)联合顺铂治疗。另外60例患者接受容积调强弧形放疗(VMAT)联合顺铂治疗。比较两组不良反应的发生情况、总生存率和复发率。采用COX回归模型分析预后不良的影响因素。

结果

两组的疾病控制率(DCR)和客观缓解率(ORR)以及总生存率和复发率无差异。IMRT组的骨髓抑制发生率远高于VMAT组。与生存组相比,死亡组患者的淋巴结转移(LNM)百分比和切缘阳性率显著增加。COX多因素分析证实,LNM和切缘阳性是影响宫颈癌患者放疗后预后不良的独立危险因素(P < 0.05)。

结论

IMRT和VMAT在宫颈癌治疗中均能取得一定效果,在短期生存复发方面效果相似。然而,VMAT的骨髓抑制发生率较低。LNM和切缘阳性是影响患者预后不良的因素。

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Comparative Analysis of VMAT and IMRT Techniques: Evaluation of Dose Constraints and Bone Marrow Sparing in Cervical Cancer Patients Undergoing Chemoradiotherapy.
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