便捷式膀胱扫描仪在子宫颈癌放疗执行中的应用及其重要性  

Application and importance of portable bladder scanner in cervical cancer radiotherapy

作　　者：吴丽华[1] 王颖[1] 靳富[1] 杨丁懿[1] 尹黎[1] 罗焕丽 

机构地区：[1]重庆市肿瘤研究所放疗科,重庆400030

出　　处：《中国医学物理学杂志》2016年第7期654-657,共4页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(11575038);重庆市卫生计生委医学科研项目(2015MSXM229);重庆市科委社会民生科技创新项目(cstc2015shmszx10013)

摘　　要：目的：研究子宫颈癌放疗中膀胱充盈变化及如何高效应用膀胱扫描仪以获取恒定膀胱体积,进一步提高子宫颈癌的放疗精度。方法：基于标准膀胱模体（标准体积133 m L）评估便捷式膀胱扫描仪测量精度。选择35例子宫颈癌患者,采用对照法（实验组20例,对照组15例）分析子宫颈癌患者在放疗执行时膀胱体积的变化,分析便捷式膀胱扫描仪在子宫颈癌放疗中的重要性。结果：不采用膀胱扫描仪时,子宫颈癌患者分次放疗膀胱体积与定位时相比平均减小41%（范围-79%~29%,中位-50%）;采用膀胱扫描仪,放疗执行中膀胱体积与定位时基本一致。膀胱体积变化时：靶区在头-脚方向上的位移为0.3~6.2 mm,CTV-PTV边界为11 mm;膀胱体积恒定时：靶区在头-脚方向上的位移为0.1~3.0 mm,CTVPTV边界为6 mm。结论：维持恒定的膀胱体积在子宫颈癌患者放疗中有着重要影响,使用膀胱扫描仪可在放疗执行中高效、便捷、快速地获取与定位时一致的膀胱体积,从而提高子宫颈癌患者的放疗精度。Objective To investigate the changes of bladder filling in the radiotherapy for cervical cancer, and to obtain constant bladder volume by effectively applying bladder scanner, further improving the radiotherapy accuracy of cervical cancer. Methods The standard bladder phantom with standard value of 133 m L was used to evaluate the measurement accuracy of portable bladder scanner. Totally, 35 patients with cervical cancer were selected, with 20 patients in experimental group and 15 patients in control group. And the contrast method was used to analyze the change of bladder volume during the radiotherapy for cervical cancer, and to analyze the importance of portable bladder scanner in the radiotherapy for cervical cancer. Results Without the bladder scanner, compared with the positioning bladder volume, the bladder volume of fractionated radiotherapy for cervical cancer reduced by 41%（-79%-29%, with a median of-50%）. With the bladder scanner, the bladder volume of radiotherapy was basically consistent with positioning bladder volume. When the bladder volume changed, the target displacement in superior-inferior direction was 0.3-6.2 mm, and the margin of clinical target volume- planning target volume（CTV- PTV） was 11 cm. When the bladder volume was constant, the target displacement in superior-inferior direction was 0.1-3.0 mm, and the CTV-PTV margin was 6 mm. Conclusion Maintaining a constant bladder volume is significant in radiotherapy for cervical cancer. During the radiotherapy, the portable bladder scanner can efficiently, conveniently and quickly obtain the bladder volume which is consistent with the positioning bladder volume, improving the radiotherapy accuracy.

关 键 词：子宫颈癌 放射治疗 膀胱体积 膀胱扫描仪 摆位误差 

分 类 号：R730.55[医药卫生—肿瘤]