The Early Efficacy Evaluation Of Clinical Application Value In Locally Advanced Cervical Cancer

Background: Cervical cancer refers to occur in the womb malignant tumors of the vagina and cervix tube.Cervical cancer is one of the most common malignant tumors in women,the present study confirmed that the main and the human papilloma virus(HPV)infection,early marriage and early childbearing,productive,and closely related to many factors such as sex disorders.Cervical cancer is the world ranking fourth of the common malignant tumor,is also a major health problem facing women.According to the survey of29 provinces,municipalities and autonomous regions show that fourth cervical cancer mortality of total cancer mortality in China,is the second most common cause of female cancer.Onset ages 40 to 50 years for most.The current treatment is given priority to with surgery and radiation and chemotherapy.About 70% of cervical cancer patients include radiation therapy,radiotherapy for all stages of cervical cancer.Local advanced(ⅠB2,ⅡA2,ⅡB,ⅢB,ⅣA)cervical cancer preferred concurrent radiotherapy and chemotherapy.Cervical cancer radiotherapy includes external beam radiotherapy(EBRT)and brachytherapy(BT).EBRT mainly for the uterine area and lymphatic drainagearea of the radiation,BT is mainly for the primary cervical lesions,the two can effectively combine to achieve a better control rate of the lesion.With the development of technology,equipment,etc.,cervical cancer radiotherapy from the traditional two-dimensional comprehensive to CT,MRI,PET / CT three-dimensional accurate radiotherapy treatment development.The traditional EBRT uses the front and back or four boxes of wild pelvic irradiation,the advantage is to ensure that the target area of radiation dose distribution uniformity,but the disadvantage is that the radiation field normal tissue to receive the dose and tumor tissue is as much,thus limiting the target Area dose increase,thus affecting the efficacy.The advantage of precise radiotherapy is to increase the dose of radiotherapy at the same time to minimize the dose of normal tissue irradiation,thereby enhancing the radiotherapy effect.The traditional BT is based on a two-dimensional radiotherapy dose analysis and dose assessment based on ICRU-38 reported dose reference point.For a localized tumor with a diameter of> 5 cm in diameter,the prescription dose line can not completely wrap around the tumor target,resulting in insufficient dose of the tumor;for a cervical local tumor with a diameter ≤5 cm,the prescription dose line includes a portion of the surrounding normal tissue that causes side effects Increase in the same time the A point set in the system in the treatment because of changes in the tumor and the difference between the location of each source,will lead to point A can not coincide,so A point dose is uncertain.So BT has also been to the development of accurate three-dimensional close-up treatment.Clinical work will be found in some cervical cancer radiotherapy patients sensitive to radiation,these sensitive patients with radiotherapy prognosis wassignificantly better than the radiotherapy part of the sensitive or insensitive patients.Radiotherapy is not sensitive to the patient is to choose to continue radiotherapy or surgery There is no standard treatment program.When to evaluate radiotherapy effects? What criteria are used? There is no definite conclusion.This study retrospectively analyzed the clinical data of locally advanced cervical cancer during the radiotherapy period,compared the prognosis of patients with different radiotherapy,and explored the strategies of individual therapy for different radiotherapy patients.Methods: A retrospective analysis of January 2011-November 2013 in our hospital,in line with the inclusion criteria of the IIb-IIIb cervical cancer patients 54 cases,all cases were in accordance with the International Union of Obstetrics and Gynecology(FIGO,2009)revised standards for clinical Staging,were diagnosed by cervical biopsy,in addition to a patient with mild renal insufficiency,there was no obvious blood,heart,liver,lung dysfunction.There were 6 cases of stage IIb,3 cases of stage IIIa,38 cases of stage IIIb,7 cases of stage IVA,and grade of cervical squamous cell carcinoma.All patients were three-dimensional moderate intensity modulated radiotherapy + cavity after the close-up radiation therapy plus platinum-like chemotherapy.All cases were externally irradiated with 30 GY pelvic CT scan + enhanced to assess the size of cervical lesions.Radiotherapy and chemotherapy side effects to symptomatic treatment.After the end of treatment,regular outpatient examination and follow-up,statistical patient prognosis(PFS,OS).Results: In patients with locally advanced cervical cancer,age,lymph node metastasis,FIGO staging of patients with chemoradiation mid-term results.The patients with lymph node metastasis,FIGO staging,and prognosis are closely related.Locally advanced cervical cancer concurrent radiotherapy and chemotherapy mid-term assessment may have a certain guiding significance for patients with PFS,and for the patient’s OS is not significant.Conclusions: Lymph node metastasis,FIGO staging in locally advanced cervical cancer synchronous radiation in the interim assessment has good clinical value.But we still need to be further observation,for the treatment of cervical cancer to provide a feasible and effective method.This study will be through the local advanced cervical cancer concurrent radiotherapy and chemotherapy in the mid-term assessment of patients with the group,the mid-term assessment of radiotherapy and chemotherapy may have a certain guiding significance for the patient’s PFS,and the significance of the OS for patients is not large,should be in the mid-After the individual treatment,the maximum possible improvement of the patient’s prognosis and quality of life.