宫颈癌患者术前预防性放疗临床研究(1)
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[摘要] 目的 探讨术前预防性放疗对宫颈癌患者手术及预后的影响。方法 选择74例子宫颈癌患者，随机分为治疗组及对照组，对照组患者明确诊断后接受手术治疗，治疗组给予两周预防性放射治疗，观察两组患者术中肿瘤切除情况、淋巴结转移情况，术后复发情况。结果 治疗组肿瘤完整切除率高于对照组 (P<0.05)，治疗组肿瘤残留率及淋巴结阳性率低于对照组(P <0.05)，术后转移率及复发率低于对照组(P<0.05)。结论 术前预防性放疗能够改善子宫颈癌手术切除率，减少术后复发及转移。
[关键词]预防性放疗；宫颈癌；切除；复发；转移
[中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701(2011)31-49-02
Effect of Prophylactic Radiotherapy to Operations and Prognosis on Patients with Uterine Cervix Cancer
YU Ying WU Xianfeng
Department of Gynaecology and Obstetrics, Zhoushan Hospital in Zhejiang Province， Zhoushan 316000， China
[Abstract] Objective To investigate the effect of prophylactic radiotherapy to operations and prognosis on patients with uterine cervix cancer(UCC). Methods Seventy-four cases of patients with UCC were randomly divided into control groups and treatment groups,patients in control groups were treated with operations, patients in treatment groups received prophylactic radiotherapy in two weeks and received treatment with operation, total excision rate, positive rate of nodus lymphaticus, relapse and metastasis rate, survival rate and time were contrasted. Results The total excision rate was higer in treatment groups than in control treatment(P<0.05), the positive rate of nodus lymphaticus was lower in treatmen than in control groups(P<0.05), relapse and metastasis rate was lower in treatment groups than in control group(P<0.05). Conclusion Preoperative prophylactic radiotherapy could improve total excision rate on UCC,and to lower risk relapse and metastasis.
[Key words] Prophylactic radiotherapy; Uterine cervix cancer；Excision; Relapse; Metastasis
子宫颈癌是常见妇科肿瘤，多数子宫颈癌对放疗、化疗敏感性较低，手术切除是主要的治疗方式，但术后复发问题是制约子宫颈癌患者手术治疗效果的瓶颈，近年来新辅助放疗技术的发展在恶性肿瘤的综合治疗中取得了理想效果，我院对子宫颈癌患者进行术前预防性放疗，取得较好的治疗效果，现报道如下。
1 资料与方法
1.1 一般资料
74例均为我院2004年1月~2007年1月住院接受手术治疗的子宫颈癌患者，年龄36~67岁，平均(51.6±12.9)岁，术后TNM分期Ⅲ期51例，Ⅳ期23例，病例入选后按随机数字表法分为治疗组和对照组各37例，对照组患者年龄36~66岁，平均(50.8±11.4)岁，治疗组患者年龄36~67岁，平均年龄(52.0±13.3)岁，两组患者年龄无显著差异。
1.2 放射治疗方法
患者入选后，对照组手术治疗，治疗组行两周期放疗，放疗应用西门子医用直线加速器，6MV- X线及 9mevβ射线，放射治疗前热体塑模，俯卧位CT扫描定位[1]，勾画放射治疗靶区，数据输入TPS 系统给出处方剂量，处方剂量为50Gy/10次，放射治疗采用3DRT模式，多个非共面野照射，每周5次，连续两周，治疗前后影像学评估效果，完成放射治疗后 3周进行手术治疗。
1.3 手术方法
两组患者术前依据临床分期及影像学资料制定手术方案 ......
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