特殊情况内膜癌的放疗课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,特殊情况内膜瘟的放疗,2016,3,特殊情况内膜瘟的放疗,1,因内科疾病无法手术的内膜癌,因内科疾病无法手术的内膜癌,2,特殊情况内膜癌的放疗课件,3,特殊情况内膜癌的放疗课件,4,Systemic review: Radiation therapy alone in,medical non-operable endometrial carcinoma,纳入25项研究,2694例单纯放疗的患者,1976-2013年,分期I-,治疗方式,比例,体外+近距离,1278(47.4%),单纯近距离放疗1383(513%,单纯体外放疗33(12%),European Journal of Cancer 65(2016)172-81,Systemic review: Radiation the,5,Systemic review: Radiation therapy alone in,medical non-operable endometrial carcinoma,治疗效果,副反应,指标,95%CI,治疗方式,3级副反应,5年疾病特异78.5%74.5%,EBRI+BI,生存率DSS,BT alone,2.8%,5年局控率LC799%757%,EBRT alone 1,84.1%,需外科千预1.6%( range:0-5%),5年总生存率53.2%49.3%,OS,57.1%,European Journal of Cancer 65(2016)172-81,Systemic review: Radiation the,6,mage-based three-dimensional conformal brachytherapy for,medically inoperable endometrial carcinoma,1期内膜癌的精确放疗,共38例患者,2007-2013年,MRI/CT based HDR-BT+EBRT,CTV包括宫体、宫颈、阴道1-2cm,剂量,BT+EBRT,平均CTVD90EQD248.656724士60Gy,平均GTvD90EQD217235961380646Gy,Brachytherapy 13 (2014)542-547,mage-based three-dimensional c,7,mage-based three-dimensional conformal brachytherapy for,medically inoperable endometrial carcinoma,atient and treatment characteristics,Characteristics,Age, median,69(53-90),22(579),15,中位随访15个月,width. median,s6cm80m2年局控率90.6%,for inoperability,3(79,2年总生存率944%,4(10.5,medical comorbidities,12G316),3(79,未发生2级远期副反应,Cardiac comorbidities,5(13.2,Advanced age,cal difficulty),Stroke/risk of discontinuing anticoagulation,Thrombocytopenia,Technique,EBRT+ BT,8(474),Image-based planning modality,9(500),CT with pretreatment MRI,3(34.2),CT alone,Brachytherapy 13 (2014)542-547,mage-based three-dimensional c,8,Consensus statement for brachytherapy for the,treatment of medically inoperable endometrial cancer,Author,age patients Type radiation PC/UC So,DFS/DSS,complications (%) DID(S),10)1997-20081,HDR士EBRT75%,73(3 yrs),Inciura(20101995-19981,HDREBRT72%,Coon (2008),HDREBRT93%,008,HDREBRT71%,Nguyen(1998)1989-19971,0(3 years) 14.7(3 years),Kucera(198),Knocke 41997)1981-1992-272,Nguyen(1995)1984-19921-127,HDREBRT,1.0(8 years),Rotte(1990),I-,HDR,000633,Sorte (1989,1977-1986,American Brachytherapy Society(ABS ) Brachytherapy 14 (2015 )587-599,Consensus statement for brachy,9,Consensus statement for brachytherapy for the,treatment of medically inoperable endometrial cancer,结构影像,勾画定义,GTVT2加权可见病灶,CTMR/CT全部宫体、宫颈、,上1-2cm阴道,OAR MRI/CT乙状结肠、直肠,膀胱、肠管、未,累及的下1/3阴,American Brachytherapy Society(ABS ) Brachytherapy 14 (2015 )587-599,Consensus statement for brachy,10,特殊情况内膜癌的放疗课件,11,特殊情况内膜癌的放疗课件,12,特殊情况内膜癌的放疗课件,13,特殊情况内膜癌的放疗课件,14,特殊情况内膜癌的放疗课件,15,特殊情况内膜癌的放疗课件,16,特殊情况内膜癌的放疗课件,17,特殊情况内膜癌的放疗课件,18,特殊情况内膜癌的放疗课件,19,特殊情况内膜癌的放疗课件,20,特殊情况内膜癌的放疗课件,21,特殊情况内膜癌的放疗课件,22,特殊情况内膜癌的放疗课件,23,特殊情况内膜癌的放疗课件,24,特殊情况内膜癌的放疗课件,25,特殊情况内膜癌的放疗课件,26,特殊情况内膜癌的放疗课件,27,特殊情况内膜癌的放疗课件,28,特殊情况内膜癌的放疗课件,29,特殊情况内膜癌的放疗课件,30,特殊情况内膜癌的放疗课件,31,特殊情况内膜癌的放疗课件,32,特殊情况内膜癌的放疗课件,33,