黄维, 李英, 龙强, 鲁文力, 姜庆丰, 谭本旭, 田丽娟, 罗弋, 肖英, 方文姬. 中晚期宫颈癌患者调强放疗与同步推量调强放疗预后比较[J]. 国际放射医学核医学杂志, 2016, 40(6): 429-434. DOI: 10.3760/cma.j.issn.1673-4114.2016.06.006
引用本文: 黄维, 李英, 龙强, 鲁文力, 姜庆丰, 谭本旭, 田丽娟, 罗弋, 肖英, 方文姬. 中晚期宫颈癌患者调强放疗与同步推量调强放疗预后比较[J]. 国际放射医学核医学杂志, 2016, 40(6): 429-434. DOI: 10.3760/cma.j.issn.1673-4114.2016.06.006
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Wei Huang, Ying Li, Qiang Long, Wenli Lu, Qingfeng Jiang, Benxu Tan, Lijuan Tian, Yi Luo, Ying Xiao, Wenji Fang. Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy: a comparative study of 277 patients with advanced cervical cancer[J]. Int J Radiat Med Nucl Med, 2016, 40(6): 429-434. DOI: 10.3760/cma.j.issn.1673-4114.2016.06.006
Citation: Wei Huang, Ying Li, Qiang Long, Wenli Lu, Qingfeng Jiang, Benxu Tan, Lijuan Tian, Yi Luo, Ying Xiao, Wenji Fang. Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy: a comparative study of 277 patients with advanced cervical cancer[J]. Int J Radiat Med Nucl Med, 2016, 40(6): 429-434. DOI: 10.3760/cma.j.issn.1673-4114.2016.06.006
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中晚期宫颈癌患者调强放疗与同步推量调强放疗预后比较

Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy: a comparative study of 277 patients with advanced cervical cancer

    摘要
  • 摘要:
    目的 探讨同步推量调强放疗（SIB-IMRT）技术治疗中晚期宫颈癌患者的不良反应、远期疗效及相关预后因素。
    方法 回顾性分析2009年1月至2015年6月收治的277例中晚期未手术的宫颈癌患者，其中70例行IMRT，207例行SIB-IMRT。比较中晚期宫颈癌患者行IMRT与SIB-IMRT后的不良反应，并进行远期疗效及预后因素分析。采用Kaplan-Meier法计算生存率，Cox法行多因素预后分析。
    结果 IMRT组与SIB-IMRT组的随访率均为100%。与IMRT相比，SIB-IMRT未增加患者直肠及膀胱的急性毒性反应（χ2=0.306和0.971，P均>0.05）和远期毒性反应（χ2=0.014和0.381，P均>0.05）。IMRT组及SIB-IMRT组患者1年总生存率（OS）分别为100%和99.5%，3年OS分别为75.0%和84.7%，差异无统计学意义（χ2=0.339和0.674，P均>0.05）。患者年龄和治疗前淋巴结状态是所有入组患者（χ2=7.971和15.938，P均 < 0.05）及SIB-IMRT组患者（χ2=7.503和10.048，P均 < 0.05）生存的预后影响因素。
    结论 初步结果表明SIB-IMRT技术安全可行，且可以减少后装治疗次数，减轻患者后装治疗的不适及痛苦。对于中晚期宫颈癌患者，SIB-IMRT是一种可尝试的外照射技术。

     

    Abstract:
    Objective To explore the toxicity, long-term overall survival(OS), and prognostic factors in advanced cervical cancer treated with IMRT and simultaneous integrated boost-intensity modulated radiation therapy(SIB-IMRT).
    Methods A retrospective analysis was performed on 277 patients with advanced cervical cancer. These patients were admitted from January 2009 to June 2015. Among the 277 patients, 70 patients received IMRT, and 207 patients received SIB-IMRT. Toxicities, survival rates, and prognostic factors were compared between the two groups. The Kaplan-Meier method was used to calculate the survival rates, and the Cox model was used for multivariate prognostic analysis.
    Results The follow-up rate was 100% in both the IMRT and SIB-IMRT groups. Compared with IMRT, SIB-IMRT showed no significant differences in acute proctitis and cystitis toxicities(χ2=0.306, 0.971, both P>0.05), as well as in long-term toxicity(χ2=0.014, 0.381, both P>0.05). The 1-year OS rates for the IMRT and SIB-IMRT groups were 100% and 99.5%, respectively, and the 3-year OS rates were 75.0% and 84.7%, correspondingly(χ2=0.339, 0.674, both P>0.05). The age and status of the pretreatment lymph nodes were the prognostic factors for all patients(χ2=7.971, 15.938, both P < 0.05), including the SIB-IMRT group(χ2=7.503, 10.048, both P < 0.05) in terms of OS.
    Conclusion Results indicated that SIB-IMRT can feasibly treat advanced cervical cancer. SIB-IMRT is a promising alternative treatment for patients who are not fit for brachytherapy treatment; this method also helps to reduce treatment fractions. Hence, SIB-IMRT is a recommended external beam technology for cervical cancer treatment.

     

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