【摘要】：目的:評價同步放化療聯(lián)合伽馬刀治療伴盆腔淋巴結(jié)轉(zhuǎn)移宮頸癌的療效及不良反應。方法:回顧性分析42例內(nèi)蒙古醫(yī)科大學附屬醫(yī)院說明放療科同步放化療治療伴淋巴結(jié)轉(zhuǎn)移宮頸癌患者。外照射三維適形調(diào)強放療(IMRT)的盆腔劑量PTV為50.4 Gy/28 F,淋巴結(jié)劑量為PGTVnd 59.92 Gy/28 F,聯(lián)合腔內(nèi)照射劑量為36 Gy/6 F。同步化療方案為順鉑40 mg/m2/周,靜脈滴注。同步放化療結(jié)束后3個月復查,對淋巴結(jié)仍有殘存患者行局部伽馬刀治療,劑量為10~15 Gy/3~4 F。結(jié)果:3個月近期療效為83.3%(35/42)。6、9、12個月局部控制率分別為88.1%(37/42)、83.3%(35/42)、80.0%(32/40)。1、2年生存率分別為77.5%(31/40)、70.0%(28/40)。主要不良反應包括放射性小腸炎[11.9%(5/42)]、直腸炎[38.1%(16/42)]、膀胱炎[7.1%(3/42)]、消化道反應[90.5%(38/42)]與粒細胞減少[85.7%(36/42)],其中絕大多數(shù)為1~2級反應。結(jié)論:同步放化療聯(lián)合伽馬刀治療伴盆腔淋巴結(jié)轉(zhuǎn)移宮頸癌療效較好,不良反應在可接受范圍之內(nèi),是臨床可行的治療手段。
[Abstract]:Objective: to evaluate the efficacy and side effects of synchronous radiotherapy and chemotherapy combined with gamma knife in the treatment of cervical cancer with pelvic lymph node metastasis. Methods: 42 patients with cervical cancer with lymph node metastasis were treated with radiotherapy and chemotherapy in affiliated Hospital of Inner Mongolia Medical University. The pelvic dose PTV was 50.4 Gy/28 F, the lymph node dose was PGTVnd 59.92 Gy/28 F, and the combined intracavitary irradiation dose was 36 Gy/6 F. The synchronous chemotherapy regimen was DDP for 40 mg/m2/ weeks, intravenous drip. Three months after simultaneous radiotherapy and chemotherapy, patients with residual lymph nodes were treated with local gamma knife at a dose of 10 鈮，

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