目的:探讨宫颈癌体外放射治疗加后装腔内治疗的疗效和放射反应。方法:对76例宫颈癌患者均采用体外放射治疗加60Co 后装腔内治疗临床资料进行回顾性分析。结果:全组 5年总生存率为 63.7%,Ⅰ期生存率为88.9%,Ⅱ期为 71.9%,Ⅲ期为48.1%,Ⅳ期为 20.0%。10年总生存率为 31.6%,Ⅰ期生存率为 53.3%,Ⅱ期为33.3%,Ⅲ期为 22.0%,Ⅳ期为 0.0%,经Log Rank法检验各期生存率有显著差异(Plt;0.01)。放射治疗后发生阴道粘连 9例(11.8%),放射性膀胱炎 6例(7.9%),放射性直肠炎13例(17.1%)。放射性直肠炎按 RTOG 晚期放射损伤分级方案分级,1级7例(53.8%),2级4例(30.8%),3级 2例(15.4%),4级 0例(0.0%)。结论:体外放射治疗加60Co后装腔内治疗宫颈癌疗效肯定,副作用少。但如何进一步提高生存率,尽可能减少放射反应仍是今后研究的方向。
ObjectiveTo systematically evaluate the efficacy and safety of 125I seed interstitial implantation for lung cancer. MethodsWe searched PubMed, The Wiley Online Library, Elsevier, CNKI, VIP and WanFang Data from inception to February 2014 to collect randomized controlled trials (RCTs) of 125I seed interstitial implantation in the treatment of lung cancer. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using RevMan 5.1 software. ResultsA total of 23 RCTs involving 1 492 patients were included. The results of meta-analysis showed that:the effective rate (OR=3.43,95%CI 2.71,4.33,P<0.000 01), 1 year survival rate (OR=2.83, 95%CI 2.03 to 3.95, P<0.000 01) and 2 year survival rate (OR=2.49, 95%CI 1.60 to 3.88, P<0.000 01) in the 125I seed interstitial implantation group were higher than those in the control group, but the rate of postoperative complications was higher than that of control group (OR=19.72, 95%CI 11.63 to 33.45, P<0.000 01). In addition, there were no significant differences between both groups in the 3 year survival rate (OR=2.45, 95%CI 0.21 to 28.89, P=0.48) and the adverse reaction rate (OR=0.74, 95%CI 0.52 to 1.05, P=0.09). Conclusion125I seed interstitial implantation is effective in the treatment of lung cancer. It can improve treatment efficiency and short-time survival rate, but may increase the rate of complications such as pneumothorax, seed malposition, bleeding and so on. Due to the limited quality and quantity of included studies, more high quality and larger sample studies are needed to verify the above conclusion.