Chinese Clinical Oncology

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Comparison on efficacy of two kinds of lead brick treatment modalities in the fourfield whole pelvic irradiation for cervical cancer with uterus excursion

LIN Gaojuan, LIU Taowen, XU Lirong, YE Shiqi, FENG Kaiyong, ZHAO Huiling.   

  1. Department of Oncology,Nanxishan Hospital of Guangxi
  • Received:2015-08-04 Revised:2015-10-12 Online:2015-12-31 Published:2015-12-31

Abstract: Objective To investigate the efficacy and safety of the whole pelvic fourfield irradiation therapy for middle and advancedstage cervical cancer with uterus excursion. Methods From Jan. 2009 to Mar. 2013,108 patients pathologically diagnosed as ⅡBⅣA cervical cancer received concurrent chemoradiotherapy. When patients received the whole pelvic irradiation to 34-40 Gy/17-20 f, they were measured distance interrelations between uterine axis(in the A point section of uterus) under the simulator. Seventy cervical cancer patients with uterus excursion were divided randomly into observation group (35 patients) and control group (35 patients). Patients in the observation group used with lead brick along with the uterine central axis in the fourfield whole pelvic irradiation in conventional fractionation. Patients in the control group used with lead brick along with the pelvic central in the fourfield whole pelvic irradiation in conventional fractionation. They all received 15-20 Gy/8-10 f, respectively. The shortterm efficacy, survival rate, local recurrence rate and toxicity were observed in two groups. Results The complete remission rate and recurrence rate in observation group and control group were 94.29% vs.74.29%, 5.71% vs.22.86%, respectively, with significant statistically differences (P<0.05). The 1-, 2-year survival rate of patients in observation group and control group were 94.29%, 82.86% and 85.71%, 71.43%, respectively. There were no significant statistically differences in two groups (P>0.05). The major toxicity was myelosuppression, gastrointestinal tract, radiation cystitis and radiation proctitis. There were no significant statistical differences for the incidence of toxicity in two groups (P>0.05). Conclusion It is suggested that fourfield whole pelvic irradiation which used lead brick along with the uterine central axis for cervical cancer with uterus excursion can decrease the dosage “cold point” and improve the complete remission rate, as well as reduce the local recurrence rate.

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