子宮頸癌根治的放射線治療における腟晩期有害事象の検討

Analysis of vaginal late adverse events of radical radiotherapy for patients with cervical cancer

子宮頸癌に対する放射線治療は手術と並んで根治的局所療法として施行されている。放射線治療は早期から進行期まで広い適応がある。また，主にシスプラチンを用いた同時化学放射線療法（concurrent chemoradiation therapy：CCRT）が予後の改善に有用とされ，広く行われている。

We retrospectively analyzed vaginal late adverse events of 124 cervical cancer patients who underwent radical radiotherapy in 2008-2018. Majority of the patients in the present study were treated with external-beam radiotherapy for pelvis and two-dimensional planning brachytherapy. 3-year actuarial estimate for ≧grade 2 and ≧grade 3 were 21.2％ and 4.1％, respectively. In multivariate analysis, total dose of ICRU-RP（odds ratio＝3.3；p＝0.046）was the risk factor for vaginal morbidity. ICRU-RP seemed to be useful as an evaluation point for vaginal adverse events. Central shielding during intracavitary irradiation contributed to the reduction of vaginal adverse events by decreasing the dose of ICRU-RP.