Clinical curative effect of three-dimensional conformal radiotherapy and intensity modulated radiation therapy on postoperative patients with cervical cancer

Abstract

Objective To retrospectively analyze the clinical efficacy of three dimensional conformal radiotherapy and intensity modulated radiation therapy on postoperative patients with cervical cancer. Methods Seventy-eight cases of cervical cancer patients were treated with radical hysterectomy. According to the postoperative radiotherapy plan, the patients were divided into the observation group and the control group, with 39 cases in each group. The observation group received intensity modulated radiation therapy, and the control group received three-dimensional conformal radiotherapy after operation. The planning target volume (PTV) indexes [minimum radiation dose (Dmin), maximum irradiation dose (Dmax), mean radiation dose (Dmean), conformal index (95%CI), uniformity index (HI)], the percentage of irradiated volume under the organs at risk (OAR) prescription dose V45 level, the incidence of adverse reaction during chemotherapy and the recurrence rate of cervical cancer during the period of follow-up between the two groups were compared. Results ①PTV dosimetric indicators: the Dmin and Dmean in the observation group were lower than those in the control group, and 95%CI was higher than that in the control group(P 0.05). ②The percentage of irradiated volume under the OAR prescription dose V45 level: at the prescribed dose of V45, the percentage of radiation volume in the bladder, rectum, small intestine, bone marrow and femoral head of the observation group was lower than that of the control group(P 0.05). ④Prognosis: there was no significant difference in the 1-year recurrence rate [2.56%(1/39) vs. 7.69%(3/39)] or 2-year recurrence rate [7.69%(3/39) vs. 12.82%(5/39)] between the observation group and the control group(P>0.05). Conclusions Compared with the three dimensional conformal radiotherapy, IMRT can achieve better target dose distribution, and to some extent, it can reduce the volume of irradiated organs at risk. It is helpful to reduce the incidence of adverse reaction such as bone marrow suppression, but it has no significant advantage on the recurrence rate of cervical cancer. Key words: Radical hysterectomy; Three dimensional conformal radiotherapy; Intensity modulated radiation therapy; Safety; Prognosis