应用四场门静脉主动脉旁照射治疗宫颈癌的临床疗效。

T Kodaira, K Karasawa, T Shimizu, Y Tanaka, T Matsuda, A Murakami, K Mizutani
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引用次数: 4

摘要

paraortic nodal照射(PAI)被认为是治疗宫颈癌的有效方法,但其较高的发病率限制了其临床应用。为了减少这种发病率,我们在PAI中常规应用四场技术。为明确其疗效,回顾性分析临床资料。在1976年至1994年间接受过至少40戈瑞的主动脉旁辐射的97名宫颈癌患者被纳入分析。采用10 MV光子(平均50.4 Gy,范围40-70 Gy)的四场通道进行PAI治疗。5年病因特异性生存率为32.2%。在使用法语-意大利语词汇表确定的后遗症中,胃和十二指肠的G1a/G2a发生率为26.8/1.0%,小肠的G2b发生率为3.1%,非特异性腹部症状和/或体征的G1b发生率为12.4%,骨骼的G2发生率为3.1%。有手术史组胃肠道并发症发生率略高于无手术史组,但差异无统计学意义。在PAI中应用四场通道是有用的,具有可接受的低毒性和中至高剂量照射的成功依从性。这表明PAI可能对改善宫颈癌的治疗效果有很大的帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical efficacy of applying four-field portals to paraaortic irradiation in the treatment of cervical carcinoma.

Paraaortic nodal irradiation (PAI) was thought to be useful in the treatment of cervical cancer, but its clinical application has been limited by a relatively high morbidity. To reduce this morbidity, we routinely applied the four-field technique in PAI. To clarify its efficacy, clinical data were retrospectively analyzed. Ninety-seven patients with cervical cancer, who received a minimum 40 Gy of paraaortic irradiation between 1976 and 1994, were enrolled in the analysis. The patients were prescribed PAI using four-field portals with 10 MV photons (mean 50.4 Gy, range 40-70 Gy). The 5-year cause-specific survival rate was 32.2%. As for sequelae determined using the French-Italian glossary, G1a/G2a of stomach and duodenum developed in 26.8/1.0%, G2b of small bowel in 3.1%, G1b of nonspecific abdominal symptoms and/or signs in 12.4%, and G2 of bone in 3.1%. The operative history group had a slightly larger incidence of gastrointestinal complications than those without operative history, but the difference was not statistically significant. Application of four-field portals in PAI was useful, with acceptably low toxicity and successful compliance for moderate-to-high dose irradiation. This suggests that PAI may greatly contribute to the improvement of the therapeutic outcome of cervical carcinoma.

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