宫颈癌是妇女中第四常见的癌症和癌症死亡的第四大原因。本研究探讨了超声CT引导下的三维腔内和间质放射治疗（US-CT-3D-IGBT）在治疗有出血的较大宫颈癌中的有效性和安全性。对31例有阴道出血的大面积宫颈鳞状细胞癌（肿瘤短径>4 cm）患者进行了回顾性研究。采用US-CT-3D-IGBT对宫颈肿瘤给予单剂高剂量处方靶区体积（HR-CTV）1000至1200厘蓄 (cGy) 的治疗，随后进行常规调强放射治疗（IMRT）同步化疗（45-50格雷(Gy)/25-28次(f)），化疗药物为顺铂25 mg/m2。外放射疗后，进行简单腔内放射治疗（BT）并结合手动间质放射治疗，给予30 Gy/5次或28 Gy/4次的剂量。在高剂量三维腔内和间质放射治疗后的24小时内，有2例患者（6.4%）的出血停止，48小时内共有11例患者（35.4%）的出血减少。共有29例患者在72小时内达到止血，有效率为93.5%。余下的2例患者于第4天和第5天达到临床止血要求。初步放射治疗后，所有患者在阴道出血方面均有显著减少，平均减少66 mL（160 mL至20 mL）。US-CT-3D-IGBT在迅速控制较大宫颈癌（肿瘤短径>4 cm）出血方面具有显著效果，治疗相对安全可行。版权所有©2023作者。由Wolters Kluwer Health, Inc.出版。

Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women. This study explored the effectiveness and safety of ultrasound-CT guided 3D intracavitary and interstitial brachytherapy (US-CT-3D-IGBT) in the treatment of larger cervical cancer with bleeding. A retrospective study was conducted on 31 patients with larger cervical squamous cell carcinoma (tumor short diameter >4 cm) with vaginal bleeding. US-CT-3D-IGBT was used to deliver a single high-dose prescription of high-risk clinical target volume (HR-CTV) 1000 to 1200 centigray (cGy) to the cervical tumor, followed by conventional intensity-modulated radiation therapy (IMRT) synchronous chemoradiotherapy (45-50 gray (Gy)/25-28 fraction(f)) with weekly cisplatin 25 mg/m2. After external radiotherapy, simple intracavitary brachytherapy (BT) combined with manual interstitial BT was administered at 30 Gy/5F or 28 Gy/4F. Within 24 hours after high-dose 3D-IGBT, bleeding stopped in 2 patients (6.4%), and bleeding was reduced in a total of 11 patients (35.4%) within 48 hours. A total of 29 patients achieved hemostasis within 72 hours, with an effective rate of 93.5%. The remaining 2 patients reached the clinical hemostasis requirement on the 4th and 5th day. All patients experienced a significant reduction in vaginal bleeding after the initial BT, with an average reduction of 66 mL (160-20 mL). US-CT-3D-IGBT is effective in rapidly controlling bleeding in patients with larger cervical cancer (tumor short diameter >4 cm), and the treatment is relatively safe and feasible.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.