Clinical Value Of Intensity Modulated Radiotherapy In Postoperative Radiotherapy For Cervical Cancer

ObjectiveTo observe the short-term efficacy and adverse reactions of intensity modulated radiotherapy and conventional radiotherapy after cervical cancer surgery,and discuss clinical value of intensity modulated radiotherapy in postoperative radiotherapy for cervical cancer.MethodsWe retrospectively analysed 60 cases of cervical cancer patients with high-risk factors admitted to Linyi Cancer Hospital from October 2012 to October 2014.Clinical stage was IB ~IIA.The surgical method is extensive hysterectomy and pelvic lymphnode dissection.Intensity modulated radiation therapy(IMRT)was selected in 30 patients,and conventional radiation therapy(CRT)in 30 patients.Intensity modulated radiotherapy used 6mv-x ray 7 field irradiation,and the prescribed dose was 45Gy/ 1.8gy /f/25 f.Conventional radiotherapy used 6mv-x ray anterior-posterior two field penetration irradiation,the prescription dose of 45Gy/ 1.8gy /f/25 f.Patients in two groups had the same after-loading treatment scheme,the reference point was 5mm under the vaginal mucosa,and the total dose was 20 Gy.The chemotherapeutic regimen was the same:cisplatin 40 mg / ? intravenous drip,once a week,6-8 times.Then we observed the short-term efficacy of the two groups.The statistical significance of the following items was compared between the two groups,including acute gastrointestinal reaction,bladder reaction,hematological toxicity,late radiological reaction of rectum and bladder,survival rate of 1-year,2-year and 3-year,recurrence and metastasis rate of 3-year.ResultsThe 1-year,2-year and 3-year survival rate in the CRT group was respectively 96.7%,90% and83.3%.The 1-year,2-year and 3-year survival rate of the IMRT group was respectively 100%,93.9% and 86.7%.There was no significant difference between the two groups(P>0.05).The3-year recurrence and metastasis rate was 20% in the CRT group and 16.7% in the IMRT group.There was no significant difference between the two groups(P>0.05).The incidence of bone marrow suppression during radiotherapy was respectively 90% and 80%,and Grade I-II was the main grade.There was no significant difference between the two groups(P>0.05).The incidence of grade 1-2 bladder reaction was 26.7% and 6.7%,respectively(P<0.05).The incidence of gastrointestinal reactions was 70% and 26.7%,respectively(P<0.05).The incidence of radiationproctitis with advanced complications was 33.3% and 13.3%,respectively(P<0.05).The incidence of radioactive cystitis was 26.7% and 6.7%,respectively(P<0.05).There was significant difference between these two groups.But there was no significant difference in sexual quality and perimenopausal symptoms between the two groups(P>0.05).ConclusionThe application of intensity modulated radiotherapy instead of conventional radiotherapy after cervical cancer surgery and did not affected the short-term efficacy.However,it could significantly reduce the toxic reaction of radiotherapy,protect the organs at risk,and improve the quality of life of patients,which was worthy of clinical application.