宫颈癌宫旁残留两种后程加量方式剂量学比较  

Dosimetry Comparison of 2 Types of Late Vestigal Dosages Mode Side with Cervical Neoplasms

作　　者：钟沛霖[1] 冯梅[1] 程燕铭[1] 李秀华[1] 郭爱华[1] 蔡勇君[1] 

机构地区：[1]福建省肿瘤医院,350014

出　　处：《实用癌症杂志》2016年第3期428-430,共3页The Practical Journal of Cancer

摘　　要：目的对三维宫旁插植后装放疗与体外调强放射治疗在宫颈癌放疗后宫旁残留后程加量中对靶区、膀胱、乙状结肠及直肠的剂量学对比研究。方法 12例局部晚期宫颈癌在完成全部放疗后宫旁残留进行宫旁后程加量,用ONCENTRA治疗系统分别设计三维后装放疗计划及体外调强放射治疗计划。利用体积直方图分别评价膀胱、直肠、乙状结肠的受照剂量;比较两组间膀胱、直肠、乙状结肠受照剂量的差别。结果两种放疗方法均能很好覆盖靶区,满足计划要求,三维插植后装放疗直肠剂量在1 cm3、2 cm3、5 cm3时分别为(3.24±1.21)Gy、(2.98±1.01)Gy、(2.43±0.87)Gy,膀胱平均剂量在1 cm3、2 cm3、5 cm3时分别为(2.04±0.58)Gy、(1.82±0.56)Gy、(1.46±0.32)Gy,乙状结肠平均剂量在1 cm3、2 cm3、5 cm3时分别为(1.37±0.61)Gy、(0.91±0.24)Gy、(0.76±0.19)Gy。体外调强放射治疗直肠剂量在1 cm3、2 cm3、5 cm3时分别为(4.84±1.34)Gy、(4.32±1.12)Gy、(3.76±1.01)Gy,膀胱剂量在1 cm3、2 cm3、5cm3时分别为(3.43±1.12)Gy、(3.10±1.02)Gy、(2.69±1.01)Gy,乙状结肠平均剂量在1 cm3、2 cm3、5 cm3时分别为(2.37±0.98)Gy、(2.05±0.78)Gy、(1.77±0.88)Gy。与体外调强放疗计划对后程加量中相比,三维宫旁插植后装放疗对直肠、乙状结肠、直肠的剂量更低,存在统计学差异(P<0.01)。结论 CT图像引导下三维宫旁插植后装放疗在宫旁残留后程加量中对膀胱、乙状结肠及直肠的保护更好,将能降低膀胱、乙状结肠、直肠并发症出现概率。Objective To study the dosimetry comparison in target section, bladder, sigmoid flexure and rectal between three-dimensional brachytherapy afterloading radiotherapy side with cervical neoplasms and external intensity-modulated radiotherapy processing the late vestigal dosages side with cervical neoplasms after the cervical neoplasms radiotherapy. Methods Implement the late vestigal dosages side with cervical neoplasms to 12 cases carrying locally advanced cervical neoplasms after completing the cervical neoplasms radiotherapy. Apply the ONCENTRA treatment system to design the three-dimensional after loading radiotherapy plan and the external intensity-modulated radiotherapy plan. Evaluate the exposure of bladder, rectum and sigmoid flexure by applying the volume histogram; compare the distinction of the exposure of bladder, rectum and sigmoid flexure of the 2 groups. Results The 2 kinds of radiotherapy can both cover the target section effectively and meet the requirement of the plan. The dosage of three-dimensional brachytherapy after loading radiotherapy rectum were 3.24 ±1.21,2.98 ± 1.01,2.43 ± 0.87 at the 1 cm^3 ,2 cm^3 、5 cm^3. The average dosage of bladder were 2.04 ±0.58 Gy,1.82 ±0.56 Gy,1.46 ±0.32 Gy at 1 cm^3 ,2 cm^3, 5 cm^3. The average dosage of sigmoid flexure were 1.37 ±0.61 Gy,0.91 ±0.24 Gy,0.76 ±0.19 Gy at 1cm^3 ,2 cm^3 ,5 cm^3. The dosage of external intensity-modulated radiotherapy of rectum were 4.84 ± 1.34 Gy,4.32 ±1.12 Gy,3.76±1.01 Gy at 1 cm^3 ,2 cm^3、5cm^3. The dosage of bladder were 3.43 ±1.12 Gy ,3. 10 ± 1.02 Gy ,2.69 ± 1.01 Gy at 1cm^3 ,2cm^3 ,5 cm^3. The dosage of sigmoid flexure were 2.37 ±0.98 Gy,2.05 ±0.78 Gy,1.77 ±0.88 Gy at 1 cm^3 ,2 cm^3 ,5cm^3. Compared with the late dosage of external intensity-modulated radiotherapy plan, the dosage of three-dimensional brachytherapy after loading radiotherapy towards rectum, sigmoid flexure and rectal was lower, there had the statistics difference. Conclusion Guiding with CT image, three-dimensional brachytherapy after loa

关 键 词：宫颈肿瘤 近距离治疗 调强放疗 剂量学 

分 类 号：R737.33[医药卫生—肿瘤]