金属节育环对局部进展期宫颈癌调强放疗影响的探讨  

Influence of intensity modulation radiated therapy from metal contraceptive ring for locally advanced cervix cancer

作　　者：张建文 杨金平 何娅 庞浩文 杨波 许锦辉 

机构地区：[1]四川医科大学附属第一医院肿瘤科,四川泸州646000

出　　处：《中华肿瘤防治杂志》2016年第1期45-48,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的宫颈癌是常见肿瘤,年轻化趋势明显,放疗是宫颈癌有效治疗措施。金属节育环是女性常用的节育措施。金属节育环与宫颈癌调强放疗的临床剂量学关系尚不清楚。因此,本研究主要分析金属节育环与局部进展期宫颈癌调强放疗剂量学的关系。方法 2013-01-01—2014-12-31四川医科大学附属第一医院肿瘤科治疗的符合入选标准的局部进展期宫颈癌患者中,信封随机法选择10例,分为金属节育环组(5例)和无金属节育环组(5例),行增强模拟定位CT扫描,在CMS治疗计划系统勾画靶区(GTV、CTV和PTV)和危及器官(肠道、双侧股骨头、直肠和膀胱),设置9野调强放疗计划。放射源为6 MV X射线。评价靶区适型指数(conformity index,CI)、均匀性指数(homogeneity index,HI),靶区最小剂量、最大剂量和平均剂量以及D95、D90、D85和D80剂量,危及器官最小剂量、最大剂量和平均剂量以及D1、D2、D5、D10和D20剂量。并计算金属节育环对靶区和危及器官剂量贡献率。结果金属节育环组和无金属节育环组靶区CI分别为0.75±0.03和0.73±0.05,t=1.05,P=0.36;HI分别为1.12±0.04和1.14±0.02,t=0.54,P=0.61。金属节育环组靶区最小、最大和平均剂量以及靶区D95、D90、D85和D80高于无金属节育环组,仅CTV的D85、D80和PTV的D80差异有统计学意义,t值分别为3.16,3.13和3.93,P值分别为0.03,0.04和0.02;其他剂量2组间差异无统计学意义,P>0.05。金属节育环对靶区剂量贡献率<5%。节育环组危及器官剂量高于无节育环组,差异无统计学意义,P>0.05。结论金属节育环对局部进展期宫颈癌调强放疗靶区和危及器官放射线剂量分布有一定影响,其剂量贡献率<5%,临床实施中可忽略。OBJECTIVE Cervical cancer is one of the common malignance with young trend evident for women. Radiotherapy is an effective treatment of cervical cancer. Metal contraceptive ring is a commonly used birth control for women. The clinical dosimetry relationship is unclear between metal contraceptive ring and intensity modulation radiated therapy （IMRT） for cervical cancer. Our main aim is to evaluate the relationship between metal contraceptive ring and do- simetry with IMRT for locally advanced cervical cancer. METHODS Ten locally advanced cervical cancer patients were randomly divided into contraceptive ring（5 cases） group and non- contraceptive ring （5 cases）group These patients were treated in our department from 01,01. 2013 to 31,12. 2014. Enhanced simulation computed tomography （Sim-CT） scan and transmitted Sim-CT image were used in CMS treatment planning system （TPS） to delineate targets （GTV,CTV and PTV） and organs at risk （intestine, right and left femoral head,rectum and bladder） for designing IMRT radiation plan with 9 fields in TPS. Radiation source was 6 MV X-ray. Conformity index （CI） and homogeneity index （HI） of target; the minimum, maximum and mean dose, and D95 , D90 , D85 , D80 of targets, the minimum, maximum and mean dose, and D1 , D2 ,D5 ,D10 and D20 of organs at risk were evaluated. The dose contribution rates for targets and organs at risk from metal contraceptive ring were calculated. RESULTS CI and HI for two groups were 0.75± 0.03,0.73±0.05 and 1.12 ± 0.04, 1.14±0.02 respectively,there were no significant differences for CI and HI of two groups （t values were 1.05 and 0.54, P values were 0.36 and 0.61 respectively）. Doses of targets for contraceptive ring group,including the minimum, maxi- mum and mean dose,and D95 ,D90 ,D85 ,D80, were higher than that of noncontraceptive ring group, but only D85 and D80 of CTV,Ds0 of PTV were significant different （t values were 3.16,3.13 and 3.93,P values were 0.03,0.04 and 0.02 respectively）,the others were

关 键 词：宫颈癌 节育环 剂量学 调强放疗 

分 类 号：R737.33[医药卫生—肿瘤]