宫颈癌近距离腔内放射治疗中膀胱和直肠ICRU参考点剂量和体积剂量受量比较  

Comparison between ICRU reference point dose and volumetric dose of bladder and rectum in brachytherapy for cervical cancer

作　　者：薛涛 刘光波[1] 袁香坤[1] 苗珺珺 何新颖[1] 刘祥 吴斌[1] 王斌[1] 闫慧娟[1] 周丽霞[1] 刘志坤[1] 孙云川[1] XUE Tao LIU Guangbo YUAN Xiangkun MIAO Junjun HE Xinying LIU Xiang WU Bin WANG Bin YAN Huijuan ZHOU Lixia LIU Zhikun SUN Yunchuan(Department of Radiotherapy, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou 061001, China)

机构地区：[1]沧州中西医结合医院放疗科,河北沧州061001

出　　处：《中国医学物理学杂志》2017年第9期897-901,共5页Chinese Journal of Medical Physics

摘　　要：目的:探讨宫颈癌腔内后装治疗中危及器官的ICRU参考点剂量和体积剂量的关系。方法:回顾性分析2016年11月~2017年3月于河北省沧州中西医结合医院接受宫颈癌腔内后装治疗的19例患者的61个治疗CT图像,通过设计治疗计划,A点剂量归一,得出计算结果,并对膀胱和直肠的受照剂量进行评估。结果:膀胱的D_(ICRU)参考点的平均剂量为(3.48±0.67)Gy,D_(2cc)体积的平均剂量为(3.53±0.58)Gy。直肠的D_(ICRU)参考点的平均剂量为(3.19±0.85)Gy,D_(2cc)体积的平均剂量为(3.43±0.71)Gy。膀胱D_(2cc)与D_(ICRU)剂量平均值的比值为1.116,直肠D_(2cc)与D_(ICRU)剂量平均值的比值为1.081。膀胱Dmax平均剂量为(4.78±0.85)Gy,直肠D_(max)平均剂量为(3.78±0.29)Gy。膀胱和直肠的D_(ICRU)点剂量和D2CC体积剂量具有相关性(膀胱:rs=0.77,P<0.001;直肠:rs=0.69,P<0.001)。结论:在危及器官受量的评估中,由DVH图得出的体积剂量要高于ICRU参考点剂量,二维计划中ICRU参考点剂量并不能代表危及器官的实际最大受照剂量。Objective To investigate the correlation between ICRU reference point dose（DICRU） and volumetric dose of organsat-risk（OAR） in the brachytherapy for cervical cancer. Methods A retrospective analysis was performed for 61 CT images of 19 patients undergoing brachytherapy for cervical cancer in Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from November 2016 to March 2017. The calculated results were obtained by designing treatment plans and normalizing point A dose, and the doses of bladder and rectum were evaluated. Results The average doses of D2cc and DICRU of bladder were（3.53±0.58） and（3.48±0.67） Gy, with a ratio（D2cc/DICRU） of 1.116, while those of rectum were（3.43±0.71） and（3.19±0.85） Gy, with a ratio（D2cc/DICRU） of 1.081. The average maximum dose（Dmax） of bladder and rectum was（4.78±0.85） and（3.78±0.29） Gy. The correlation between D2cc and DICRU in bladder and rectum was evaluated（bladder： rs=0.77, P〈0.001; rectum：rs=0.69, P〈0.001）. Conclusion The volumetric dose obtained from dose-volume histogram in the evaluation of OAR dose is higher than DICRU, so that the DICRUin two-dimensional plan cannot represent the actual maximum OAR dose.

关 键 词：宫颈癌 近距离腔内放疗 治疗计划 危及器官 剂量体积直方图 

分 类 号：R730.5[医药卫生—肿瘤]