徐律等

[摘要] 目的 评价不同计划靶体积（PTV）外扩界在三维适形放疗治疗复发性宫颈癌中的临床效果。 方法 随机选取温州市中心医院2013年1～12月收治的45例复发性宫颈癌患者作为研究对象，根据PTV外扩边界剂量不同分为三组，分别为PTV 0.5 cm组15例、PTV 1.0 cm组（常规对照组）15例、PTV 1.5 cm组15例，比较三组患者疗效及副作用发生情况。 结果 PTV 1.5 cm组患者放疗后总有效率（93.33%）明显高于常规对照组（66.67%）和PTV 0.5 cm组（60.00%）；PTV 1.5 cm组患者放射性直肠炎发生率（0.00%）明显低于常规对照组（26.67%）和PTV 0.5 cm组（26.67%），差异有统计学意义（P < 0.05）。三组患者的骨髓抑制发生率比较，差异无统计学意义（P > 0.05）。 结论 不同PTV外扩界在三维适形放疗治疗复发性宫颈癌中具有一定的差异性，PTV 1.5 cm临床总有效率更高，可明显降低放射性直肠炎的发生率，减少副作用的发生，属于最为安全的剂量范围，值得临床推广应用。

[关键词] 计划靶体积；三维适形放疗；复发性；宫颈癌；临床效果

[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0082-04

Assessment on clinical effect of different PTV outside enlarge community of three-dimensional conformal radiotherapy in the treatment of recurrent cervical cancer

XU Lü WU Qishu LIN Aidi

Department of Gynecologic Oncology， Central Hospital of Wenzhou City， Zhejiang Province， Wenzhou 325000， China

[Abstract] Objective To evaluate clinical effect of different PTV outside enlarge community of three-dimensional conformal radiotherapy in the treatment of recurrent cervical cancer. Methods 45 cases of recurrent cervical carcinoma in Central Hospital of Wenzhou City from January to December 2013 were randomly selected as study objects. They were divided into PTV 0.5 cm group （15 cases）， PTV 1.0 cm group （normal control group） （15 cases）， PTV 1.5 cm group （15 cases） according to different dose PTV outside expanding boundary. Treatment efficacy and side effect among three groups were compared. Results After radiotherapy treatment， total efficiency of PTV outside enlarge world of PTV 1.5 cm group （93.33%） was significantly higher than that of normal control group （66.67%） and PTV 0.5 cm group （60.00%） respectively， with statistical differences （P < 0.05）. After radiotherapy treatment， the incidence rate of radiation proctitis in PTV 1.5 cm group （0.00%） was significantly lower than that in normal control group （26.67%） and PTV 0.5 cm group （26.67%） respectively， with statistical difference （P < 0.05）. The incidence rate of bone marrow inhibition among three groups had no statistical difference （P > 0.05）. Conclusion In three-dimensional conformal radiotherapy treat recurrent cervical cancer， different PTV outside enlarge community has certain difference， clinical total efficiency of PTV 1.5 cm is higher， which can obviously reduce the incidence rate of radiation proctopathy， reduce the occurrence of adverse events， is worthy of promotion and application in clinic.endprint

[Key words] PTV； Three-dimensional conformal radiotherapy； Recurrence； Cervical cancer； Clinical effect

宫颈癌病变是一种常见的妇科疾病，宫颈病变进一步发展可转变为宫颈癌，严重危及患者的生命[1-3]。宫颈癌病变早期发现，早期诊断，可为治疗疾病争取更多时间，在挽救患者生命的基础上，提高患者生存质量。不同计划靶体积（PTV）外扩界三维适形放疗治疗复发性宫颈癌存在一定差异，主要在临床效果和副作用方面[4]。本文选取温州市中心医院收治的早期宫颈癌病变患者作为研究对象，分析不同PTV外扩界在三维适形放疗治疗复发性宫颈癌中的临床效果。

1 资料与方法

1.1 一般资料

选取2013年1～12月入住温州市中心医院的45例复发性宫颈癌患者为研究对象，且病例均为根治性放疗后2年内局部复发，年龄30～69岁，平均（47.12±10.23）岁。……