| Objective:The clinical efficacy and toxic side effects of intensity modulated radiotherapy and conventional radiotherapy in the treatment of advanced cervical cancer were compared.Methods:A total of 100 patients with newly diagnosed cervical cancer diagnosed as stage Ⅱb-Ⅲb treated in the Department of Obstetrics and Gynecology of the Fourth Hospital of Hebei Medical University from May 2011 to March 2013 were selected and divided into intensity-modulated radiotherapy groups according to different external radiation treatment methods.(IMRT group)50 cases and conventional radiotherapy group(CRT group)50 cases.After IMRT was used to make body membranes,CT simulation was performed.The images were transmitted to the radiotherapy planning system via the local area network to outline the target area.At the same time,rectum,bladder,small intestine,spinal cord and other endangered organs were outlined.The conventional radiotherapy was performed by X-ray simulation positioning.First,the two fields of the whole field were exposed to the front and back,and then the middle part of the field started to block lead,and then the external irradiation was continued.Patients in both groups received intracavity irradiation 3 to 4 weeks after in vitro irradiation.The dose at point A was 6 to 7 Gy / time,once per week.The course of treatment was 4 to 7 times,and the dose at point A was 24 to 42 Gy.Both groups of patients were given platinum combined with fluorouracil chemotherapy during radiotherapy,once / 4 weeks.Follow up regularly after treatment to observe the curative effect and toxicity.Results:1.The short-term efficacy was evaluated 3 months after radiotherapy: the total effective rates of the IMRT group and the CRT group were 98% and 94%,respectively,P> 0.05(P = 0.617),and the difference was not statistically significant.2.In terms of survival rates,the 1-year,3-year,and 5-year survival rates of the IMRT group were 96%,90%,and 76%,and the CRT group was 94%,84%,and 70%,respectively.The comparison between the two groups was P> 0.05(P=1.000,0.554,0.653),and the difference was not statistically significant.3.Among the acute side effects,the incidence of bladder 0,Ⅰ-Ⅱ,Ⅲ-Ⅳ grade side effects was 40%,60%,and 0 in IMRT group,and 20%,76%,and 4% in CRT group.Comparison,P <0.05(P = 0.032),the difference is statistically significant.The incidence of rectal 0,Ⅰ-Ⅱ,Ⅲ-Ⅳ grade side effects was 36%,62%,2% in IMRT group,and 16%,76%,8% in CRT group.Comparison between the two groups,P <0.05(P = 0.039),the difference is statistically significant.Bone marrow suppression 0,Ⅰ-Ⅱ,Ⅲ-Ⅳ grade incidence of side effects in IMRT group were 28%,64%,8%,CRT group was 24%,60%,16%,compared between the two groups,P> 0.05(P = 0.514),the difference was not statistically significant.4.Among chronic side effects,the incidence of bladder grades 0,Ⅰ-Ⅱ,Ⅲ-Ⅳ was 96%,2%,2% in IMRT group,92%,6%,2% in CRT group,and Comparison,P> 0.05(P = 0.807),the difference was not statistically significant.Rectal 0,Ⅰ-Ⅱ,Ⅲ-Ⅳ grade incidence of side effects were 94%,6%,and 0 in IMRT group,and 86%,6%,and 8% in CRT group.Comparison between the two groups,P> 0.05(P = 0.141),the difference was not statistically significant.Conclusions:1.In the treatment of patients with advanced cervical cancer,the clinical efficacy of intensity-modulated radiotherapy combined with conventional radiotherapy combined with intracavity radiotherapy and simultaneous chemotherapy failed to significantly improve the patients’ short-term efficacy and 1-year,3-year,and 5-year survival rates.2.Compared with conventional radiotherapy,intensity-modulated radiotherapy can alleviate the toxic and side effects of the bladder and rectum in patients with radiotherapy in the near future,which is conducive to the successful completion of patients’ treatment.3.Compared with conventional radiotherapy,IMRT failed to significantly reduce the incidence of chronic toxicities in patients. |
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