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1、特殊情况内膜癌的放疗2016-1L1-13因内科疾病无法手术的内膜癌、高龄患者比率不断增加,65岁以上悦者达18.226*尽管手术技术(阴式手术、腔镜手术等)、麻醉和围手术期管理水平不断提高、约3-9%悦者因内科合并疙或高龄无法完成手术*体外放疗近距离治疗内分泌治疗的横式可有明显获益Medicallyinoperablestage1adenocarcinomaoftheendometriumtreatedwithradiotherapyloneI期内膜癌的5年无进展生存率G194%G2925%G378%UROBP1987;13:483-8Systemicreview:Radiationther
2、apyaloneinmedicalnon-operableendometrialcarcinoma纳入25项研究李2694例单纯放疗的悦者人1976-2013年分期LIV体外+近距离1278(4744%)单纯近距离放疗1383(51.3趸)单纯体外放疗33(1.28)EuropeanJournalofCancer65(2016)172-81Systemicreview:Radiationtherapyaloneinmedicalnon-operableendometrialcarcinoma治疗效果副反应命二玲明Ez2IEqoeacoroes78.5%“745%-EBRT+BT37%生存率DS
3、S82.5%BTalone2.8%5年局控率LC“799%,757%-EBFTalone“1294841%需外科干预16%(range:0-5%)5年总生存率53.2%493%-s571%EuropeanJournalfCancer65(2016)172-81Image-basedthree-dimensionalconformalbrachytherapyformedicallyinoperableendometrialcarcinomal!期内膜癌的精确放疗。共38例患者,2007-2013年*MRI/CTbasedHDR-BT土EBRT。CTV包括宫体、宫颈、阴道1-2cmJ日日日H匕人
4、人一/BTaloneBT+EBRT平均CTVD90EQDp248.6土56“72.4土6.0Gy平均GTVD90EQD2172.3土59.6“138.0土64.6GyBrachytherapy13(2014)542-547Image-basedthree-dimensionalconformalbrachytherapyformedicallyinoperableendometrialcarcinomalPicscsndiestmentdoseiceCencensteAgeGnd1UesnesiitnetinResenerinopenbiiyPaiceeefeeeeeMetidoeayMali
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7、04NeeqgnBH。讹H874eaA16wa巳10T0死seNesemdmgMa。死HogxEhgrt0110w172100veameIn-lbsgL2ng71I60IT山巳Eeopgy-引ngE466AmericanBrachytherapySociety(ABS),Brachytherapy14(2015)587-599Consensusstatementforbrachytherapyforthetreatmentofmedicallyinoperableendometrialcancer7|GTV|T2加权可见病灶MRCTVMRVCT全部客体、客颈、1-2cm阴道OAR“MRVCTZ妆绑肠/真历蓉胱、肠管:未累及的下4/3阮道AmericanBrachytherapySociety(ABS】,Brachytherapy14(2015)587-599
