Clinical Analysis Of Intercalation Of Radiotherapy In Locally Advanced Cervical Cancer

Backgroud and ObjectiveCervical cancer is a common female malignant tumor disease.Locally advanced cervical cancer?LACC?is a tumor with a tumor diameter>4cm,no systemic metastasis,and FIGO stage between?B2^?A.Radiotherapy is the main treatment for locally advanced cervical cancer.Extraluminal irradiation combined with intracavitary irradiation is the standard radiotherapy method for LACC.The external cavity irradiation is characterized by three-dimensional conformal emphasis on radiotherapy.Intracavitary irradiation has been used in the past.Intracavitary brachytherapy?ICBT?,but the effect is still not ideal.In recent years,studies have indicated that interstitial implantable radiotherapy?ISBT?is a method of inserting implants into the tumor for brachytherapy.The advantage is that the tumor tissue is exposed to high doses while reducing the dose of surrounding normal tissue.It can meet the high dose requirement of local tumor lesions,reduce the exposure dose of normal tissues,reduce the damage of adjacent organs such as rectum and bladder,and reduce the incidence of radiotherapy complications.In recent years,there have been many studies on the application of ISBT in the treatment of LACC,but due to the lack of big data support,it has not been promoted in clinical practice.The purpose of this study was to compare the efficacy and safety of three-dimensional conformal radiotherapy combined with high-dose rate post-loading therapy?HDR-ICBT?and three-dimensional conformal radiotherapy combined with high-dose rate interstitial radiotherapy?HDR-ISBT?.Defining the value of ISBT in the treatment of LACC.Provide scientific guidance for the development of LACC clinical treatment programs.Materials and methodsFrom August 2016 to December 2017,Forty-four patients with LACC who underwent three-dimensional conformal radiotherapy combined with high-dose rate post-loading therapy?HDR-ICBT?were selected as the control group.The three-dimensional conformal radiotherapy combined with high dose was selected.Forty-four patients with LACC who underwent interstitial interplanting radiotherapy?HDR-ISBT?were used as experimental groups.All patients were informed of this study and volunteered to participate.The age,pathological type and pathological stage data of the two groups were slightly different.The comparison results were not statistically significant?P>0.05?.Comparing the clinical target area?CTV?and endangered organ?OAR?exposure dose,short-term efficacy,long-term efficacy,toxicity and quality of life improvement,and comprehensive evaluation of the application of two radiotherapy regimens in LACC treatment value,All data and information involved in the study were input into the SPSS23.0 system for analysis and treatment.Result1.The high-risk CTV D₁₀₀,high-risk CTV D₉₀,intermediate-risk CTV D₁₀₀,and intermediate-risk CTV D90 levels in the experimental group were?5.41±0.29?Gy,?7.33±0.28?Gy,?3.59±0.35?Gy,?5.24±0.47?Gy,which was significantly higher than the control group?4.30±0.57?Gy,?5.69±0.46?Gy,?2.62±0.42?Gy,?4.03±0.54?Gy,and the difference of significance of each index was P<0.05.It is statistically significant.2.In the experimental group,the levels of D_{2 cm3},rectal D_{2 cm3},sigmoid colon D_2cm3,and small intestine D_{2 cm3} cm3 were?4.08±0.33?Gy,?3.42±0.45?Gy,?3.09±0.27?Gy,?3.52±?.0.69)Gy,which was lower than the control group?5.17±0.62?Gy,?4.81±0.37?Gy,?3.84±0.46?Gy,?3.56±0.75?Gy,of which D_{2 cm3},rectal D_{2 cm3},sigmoid colon D_2cm3cm3 The data of each index showed significant difference test P<0.05,which was statistically significant.There was no significant difference in the data of small intestine D_{2 cm3},and the significance test was P>0.05.3.The experimental group ORR?77.27%?was significantly higher than the control group?59.09%?,the experimental group DCR?90.90%?was significantly higher than the control group?72.73%?,P<0.05,statistically significant.4.The patients in both groups were followed up for 12-36 months.The local recurrence rate,distant metastasis rate and mortality were significantly lower in the experimental group than in the control group.The survival rate and FFP were higher than the control group,P<0.05.Learning meaning.5.The incidence of radiation proctitis in the experimental group?22.73%?was significantly lower than that in the control group?38.64%?,the incidence of radiation cystitis?11.36%?was significantly lower than that in the control group?29.55%?,and the incidence of thrombocytopenia?27.27%?was significantly lower than the control group?52.27%?,the contrast difference test results were all P<0.05,statistically significant.Conclusion1.The effect of interstitial implantation radiotherapy in patients with locally advanced cervical cancer is better than that of intraluminal brachytherapy.2.Compared with intracavitary posterior radiotherapy,inter-tissue radiotherapy can increase the dose of clinical target area,reduce the dose of organs that are endangered,improve the recent remission rate,control rate,reduce local recurrence rate,and distant transfer rate,mortality,prolong survival and disease-free survival,reduce toxic and side effects,improve patients'quality of life,with good results and high safety.3.Interstitial implant radiotherapy should be the first choice for patients with locally advanced cervical cancer.