| Objective:A retrospective analysis of the short-term curative effect of radical radiotherapy for cervical cancer in our radiotherapy center,and a preliminary study of the effect of ir-192 radioactive source activity on the curative effect of cervical cancer radiotherapy and acute radiation injury.Methods:Selecting patients undergoing radical radiotherapy for cervical cancer who were treated with volumetric modulated arc therapy combined with Ir-192 brachytherapy at our center from January 2019 to June 2020,and exclude the replacement of radioactive sources during after-loading brachytherapy or the patients who underwent interstitial brachytherapy.Before radiotherapy,all patients were assessed by gynecologists to be inoperable or the patients refused to undergo surgical treatment.Radical radiotherapy and concurrent or inconcurrent chemotherapy were used.During External beam radiation,D95%of the prescribed dose of 50Gy was given to PTV.No more than two brachy after-loading treatments will be arranged every week in the last week or after the end of external radiation.The single dose is 6Gy,and a total of 4 or 5 after-loading treatments will be given.Record the patient’s external radiation dose,Ir-192 radioactive source activity during brachytherapy,each after-loading treatment time,90%CTV dose and volume,bladder and rectum D2cc,D0.1cc,etc.During radiotherapy,the patient’s blood routine was monitored weekly to evaluate the bone marrow suppression after radiotherapy.Gynecological examinations were performed at the end of radiotherapy,and gynecological examinations and re-examination of pelvic MRI or CT were performed one month after the end of radiotherapy to assess the short-term efficacy of the tumor.After the radiotherapy,the patients were followed up for 6 months by telephone or outpatient review.Grouped by radioactive source activity,matched propensity scores according to the patient’s age,clinical stage,pathological type,concurrent chemotherapy,90%CTV dose and volume,etc.,and then compared the after-loading treatment time,acute radiation injury,and short-term efficacy of the two groups of patients Wait for the situation.All statistical analysis of data used SPSS 22.0 software,using Wilcoxon signed rank test and other methods.The statistical difference was defined as P<0.05.Results:Efficacy evaluation of 80 patients:63 cases of CR,12 cases of PR,3 cases of SD,2 cases of PD,the effective rate of tumor treatment was 93.75%(75/80);42 cases(52.5%)developed radiation cystitis(50%for grade 1 and 2,2.5%for grade 3);49 cases(61.25%)developed radiation proctitis(57.5%for grade 1 and 2,3.75%for grade 3);most patients had different degrees of bone marrow suppression(96.2%)after radiotherapy,25 cases had grade Ⅲ or Ⅳ bone marrow suppression.The radioactive source activity 1 Ci,1.5 Ci,2Ci,2.5 Ci,3 Ci,3.5 Ci,4 Ci groupings were compared.In order to exclude the influence of confounding factors,propensity score matching was performed.There were no significant differences in the short-term efficacy(P=0.930、0.095、0.655、0.316、0.055、0.206、0.280),acute radiation cystitis(P=0.588、0.232、1.000、0.498、0.903、0.797、0.559),acute radiation proctitis(P=0.619、0.865、0.414、0.953、0.852、0.876、0.775),and bone marrow suppression(P=0.579、1.000、0.392、0.913、0.356、0.511、0.870)among the 7 groups,P>0.05.Conclusion:This study found that the short-term curative effect of radical radiotherapy for cervical cancer in our center is better,and the acute radiation injury is less.Ir-192 radioactive source activity has no significant effect on the short-term curative effect of radical radiotherapy for cervical cancer,acute radiation cystitis,acute radiation proctitis,and bone marrow suppression. |
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