中晚期宮頸癌患者運(yùn)用IMRT和VMAT治療對預(yù)后的影響

鐘曉麗　孫忠楠

【摘要】 目的：對比中晚期宮頸癌患者運(yùn)用適形強(qiáng)調(diào)放療（IMRT）和容積旋轉(zhuǎn)調(diào)強(qiáng)放療（VMAT）治療對預(yù)后的影響。方法：選取2018年6月-2019年6月筆者所在醫(yī)院收治的中晚期宮頸癌患者90例，按照隨機(jī)原則分為觀察組（VMAT治療）和對照組（IMRT治療），各45例。對比兩組近期腫瘤控制率和早、晚期不良反應(yīng)發(fā)生率。結(jié)果：觀察組近期腫瘤控制率為95.56%，與對照組的93.33%比較差異無統(tǒng)計學(xué)意義（P>0.05）;兩組早期不良反應(yīng)發(fā)生率比較，差異無統(tǒng)計學(xué)意義（P>0.05）;觀察組晚期放射性膀胱炎發(fā)生率為15.56%，放射性腸炎發(fā)生率為11.11%，均低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：對中晚期宮頸癌患者運(yùn)用IMRT和VMAT治療的近期效果相當(dāng)，且在早期不良反應(yīng)方面無顯著差異，但VMAT能夠更好地保護(hù)危及器官，晚期不良反應(yīng)較少，值得推廣應(yīng)用。

【關(guān)鍵詞】 中晚期宮頸癌 IMRT VMAT 疾病預(yù)后

doi：10.14033/j.cnki.cfmr.2020.16.014 文獻(xiàn)標(biāo)識碼 B 文章編號 1674-6805（2020）16-00-03

Effects of IMRT and VMAT on the Prognosis of Patients with Advanced Cervical Cancer/ZHONG Xiaoli， SUN Zhongnan. //Chinese and Foreign Medical Research， 2020， 18（16）： -39

[Abstract] Objective： To compare the effects of intensity modulated radiation therapy （IMRT） and volumetric modulated arc therapy （VMAT） on the prognosis of patients with advanced cervical cancer. Method： From June 2018 to June 2019， 90 patients with advanced cervical cancer admitted to the hospital were selected and randomly divided into the observation group （VMAT treatment） and the control group （IMRT treatment）， 45 cases in each group. Short-term tumor control rate and incidences of early and late adverse reactions were compared between the two groups. Result： The short-term tumor control rate in the observation group was 95.56%， compared with 93.33% of the control group， and the difference was not statistically significant （P>0.05）. The incidence of early adverse reactions was compared between the two groups， and the difference was not statistically significant （P>0.05）. In the observation group， the incidence of late radiation cystitis was 15.56%， and the incidence of radiation enteritis was 11.11%， which were lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion： The short-term therapeutic effect of IMRT and VMAT in the treatment of advanced cervical cancer is the same， and there is no significant difference in the early adverse reactions. However， VMAT can better protect the organs at risk and has fewer late adverse reactions， so it is worth promoting its application.

[Key words] Advanced cervical cancer IMRT VMAT Prognosis of disease

First-authors address： Yantaishan Hospital， Yantai City， Yantai 264025， China

宮頸癌對婦女的身體健康危害極大。在宮頸癌治療中，放療發(fā)揮著十分重要的作用，特別是對于中晚期宮頸癌患者。傳統(tǒng)的三維適形放療和兩野對穿照射很難獲得理想的靶區(qū)劑量分布，且較高劑量的照射會對靶區(qū)臨近組織如部分小腸、直腸和膀胱產(chǎn)生損傷[1-3]。近年來，隨著現(xiàn)代放療技術(shù)的不斷發(fā)展及運(yùn)用，適形強(qiáng)調(diào)放療（IMRT）和容積旋轉(zhuǎn)調(diào)強(qiáng)放療（VMAT）技術(shù)逐漸應(yīng)用于宮頸癌治療中，能夠使不同的照射劑量分布于不同的靶區(qū)組織內(nèi)，彌補(bǔ)了傳統(tǒng)治療方法的弊端。此外，IMRT和VMAT技術(shù)不僅能夠有效提高腫瘤控制率，還能降低并發(fā)癥發(fā)生率，使患者的生活質(zhì)量得到顯著改善[4-5]。本文主要探討中晚期宮頸癌患者運(yùn)用IMRT和VMAT治療對預(yù)后的影響，報道如下。

1 資料與方法

1.1 一般資料

選取2018年6月-2019年6月筆者所在醫(yī)院收治的中晚期宮頸癌患者90例。納入標(biāo)準(zhǔn)……