Clinical Study Of Concurrent Intensity-Modulated Radiotherapy And Chemotherapy For Locally Advanced Cervical Cancer

Objective To discuss the short-term effect and complications of concurrent intensity-modulated radiotherapy (IMRT) and chemotherapy for locally advanced cervical cancer (LACC).Methods From January 2007 to October 2009, 59 women diagnosed LACC were treated with radical radiotherapy in the Department of Radiation Oncology , the fourth Affiliated Hospital of the Guangxi Medical University. All the patients without the disfunction of the heart,lung,liver and kidney . Retrospective these patients'informations of clinical . All patients were treated with the combination of EBRT plus afterloading Intracavitary irradiation : EBRT were performed with 6MV-X ray in 25 to 30 fractions with a fractionted 1.8～2.2Gy Gy perday , five days per week ; After loading intracavitary irradiation was done in 5 to 8 fractions with a fractionted 7Gy per week to"A"from second or third week , and that day EBRT was not performed . concurrent chemotherapy with DDP at the dose of 40mg/㎡ once a week . The treatment group (group A) included 29 cases , who had undergone IM-WPRT . The control group (group B) included 30 cases , who had undergone two field opposed (anteroposterior) conventional external , after a dose of 20～30Gy to the whole pelvis were given , pulsing midplane blocking of lead (block the part of afterloading ). Short-term effect and complications were observed.Results Three month after radiotherapy , effective rate was 96.6% in group A and 96.7% in group B respectively(x2=0.000, P=1.000), showing no significant difference . Among the early complications , it was discovered that the incidence rates of gastrointestinal (nausea,vomiting and etc) side reaction was 86.2% in group A and 93.3% in group B respectively(x2=0.225, P=0.635); The incidence rates of rectum side reaction was 34.5% in group A and 56.7% in group B respectively(x2=2.924, P=0.087)and bladder side reaction was10.3% in group A and 23.3% in group B(x2=0.965, P=0.326). The early complications showed no significant difference(P > 0.05) ; The incidence rate of myelosuppression was 72.4%,96.7% respectively(x2=4.964, P=0.026), showed significant difference(P<0.05). The incidence rates of radiation proctitis was 10.3%,43.3% respectively(x2=8.119, P=0.004)and radiocystitis was 3.4%,26.7%(x2=4.484, P=0.034), showing significant difference in the late complications(P<0.05).Conclusions TMRT is feasible in treating of LACC for its reductions of radiation damage and complications , especially decreasing the incidence rates of myelosuppression and late complications , improving the patients'quality of life .