子宫颈癌术后调强放疗和三维适形放疗的临床疗效观察  

Clinical observation of intensity modulated radiotherapy or three dimensional conformal radiotherapy in cervical cancer patients treated with surgery

作　　者：沈志勇[1] 林建海[1] 廖绍光[1] 王玲[1] 程惠华[1] 付志超[1] 骆华春[1] 

机构地区：[1]南京军区福州总医院放疗科,福州350025

出　　处：《临床肿瘤学杂志》2016年第10期903-908,共6页Chinese Clinical Oncology

摘　　要：目的探讨子宫颈癌术后调强放疗(IMRT)与三维适形放疗(3DCRT)的临床疗效及安全性。方法选取我院2012年9月至2013年3月60例宫颈癌术后患者,均制定IMRT和3DCRT两种放疗计划,随机分为IMRT组和3DCRT组进行放疗,IMRT组行5野6MV-X射线放疗,3DCRT组行4野6MV-X射线盒式照射,处方剂量均为95%计划靶区体积(PTV)为45 Gy/25 f/5 W。评价PTV和危及器官(OAR)的剂量分布特点;随访两组OAR的急慢性放射性损伤,计算两组3年生存率。结果 IMRT组PTV的适形度指数(CI)、均匀性指数(HI)分别为0.80±0.03、1.10±0.01,3DCRT组分别为0.58±0.19、1.09±0.01,差异有统计学意义(P<0.05);IMRT组膀胱前壁的V_(10)、V_(20)、V_(30)、V_(40)和V_(45)均低于3DCRT组,差异有统计学意义(P<0.05);IMRT组直肠后壁的V_(20)、V_(30)、_(40)和V_(45)均低于3DCRT组,差异有统计学意义(P<0.05);IMRT组直肠和膀胱的急性和慢性放射性损伤发生率低于3DCRT组,差异有统计学意义(P<0.05)。IMRT组3年生存率为83.3%,3DCRT组为80.0%,差异无统计学意义(P>0.05)。结论在PTV的CI、HI及保护OAR如膀胱前壁、直肠后壁上,IMRT优于3DCRT。Objective To explore the efficacy and safety of intensity modulated radiotherapy（IMRT） and three dimensional conformal radiotherapy（3DCRT） in cervical cancer patients after the surgery. Methods IMRT and 3DCRT plans were designed for 60 cervical cancer patients after the surgery. Patients were randomly assigned to IMRT group and 3DCRT group. The dose distribution of planning target volume （PTV） and organ at risk （OAR） were evaluated. And the acute and chronic radiation injury, 3 years overall survival （OS） were compared between two groups. Results The conformation index （CI） , relative dose homogeneity index （HI） of PTV were significant different between two groups （P〈0. 05）. Compared with 3DCRT group, V10, V20, V30, V40 and V45of anterior bladder wall and the V20, V30, V40 and V45 of posterior rectal wall were significant lower in IMRT group （P〈0. 05）. And the acute and chronic radiation injury of rectal and bladder were significant slighter in IMRT group. There was no difference in 3-year survival rates between two groups. Conclusion IMRT was superior to 3DCRT in CI, HI of PTV and the protection of the anterior bladder wall and the posterior rectal wall.

关 键 词：宫颈癌 调强放疗 三维适形放疗 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]