摘要目的 探讨肿瘤中心前程同步加量调强放疗治疗巨块型宫颈癌大出血的有效性和安全性.方法 21例伴有阴道大出血的巨块型宫颈癌患者,前程(前3次)给予肿瘤中心(宫颈大肿块边界内收2 cm的范围)同步加量放疗15 Gy分3次后给予常规分割剂量(2 Gy/次),肿瘤周边和盆腔全程采用常规分割照射剂量46 Gy分23次.同步化疗采用顺铂25 mg/m2每周方案.外照射结束后给予腔内放疗20 Gy/4次.结果 首程大剂量放疗后24 h内阴道出血量较前减少50％,1周内阴道出血渐止,止血率100％.结论 采用肿瘤中心同步加量调强放疗是巨块型宫颈癌阴道大出血的有效治疗措施.

abstractsObjective To evaluate the clinical efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) to the tumor center in the treatment of bulky cervical cancer with massive bleeding in the first course radiotherapy.Methods Twenty-one cases with bulky cervical cancer complicated with massive vaginal bleeding were enrolled.At the first three times of external irradiation,a high dose radiotherapy (15 Gy/3 fractions) was delivered to the tumor center (the region retracted 2 cm from the periphery of cervical mass),followed by conventional irradiation (2 Gy/fraction) in the posterior course.Conventional dose irradiation (46 Gy/23 fractions) was given to the tumor periphery and pelvic lymphatic drainage area throughout the whole course.Concurrent chemotherapy by cisplatin at a dose of 25 mg/m2 was delivered weekly.After the external irradiation,intracavitary radiotherapy was given (20 Gy/4 fractions).Results Within 24 h after the first course radiotherapy,the volume of vaginal bleeding was significantly decreased by 50％ and the bleeding was almost stopped within one week.The hemostasis rate was 100％.Conclusions SIB-IMRT into the center of bulky cervical cancer is an efficacious treatment of massive vaginal bleeding.