CT引导下宫颈复发癌挽救性组织间插植近距离治疗剂量学分析  

Dosimetric analysis of CT-guided salvage interstitial brachytherapy for recurrent cervical cancer

作　　者：刘忠山[1] 郭杰[1] 赵杨祉[2] 林霞[1] 张志良[1] 王红勇[1] 李云峰[1] 任晓俊[1] 张冰雅 王铁君[1] 

机构地区：[1]吉林大学第二医院肿瘤放疗科,长春130041 [2]吉林大学第一医院肿瘤中心,长春130021

出　　处：《中华放射肿瘤学杂志》2018年第1期74-78,共5页Chinese Journal of Radiation Oncology

摘　　要：目的CT引导下组织间插植近距离治疗宫颈复发癌患者的新方法，分析其剂量学优势。 方法16例接受过手术和术后辅助性体外放疗的宫颈复发癌患者接受了CT引导下金属针植入的组织间插植治疗。给予高危临床靶区（HR-CTV）6 Gy 6次剂量。评价本次近距离治疗肿瘤靶区HR-CTV D90；之前的体外照射和本次近距离治疗累加的膀胱、直肠及乙状结肠D2 cm3值。结果HR-CTV D90的平均值为（52.5±3.3） Gy。膀胱、直肠、乙状结肠累加D2 cm3分别为（85.6±5.8）、（71.6±6.4）、（69.6±5.9） Gy。每次近距离治疗金属针的平均使用量为（6.1±1.5）。实际1年OS、LC分别为81%、69%。结论CT引导下组织间插植近距离治疗对宫颈复发癌具有很好的DVH参数和较小的并发症，或许临床是可行的，但其远期临床结果尚待进一步观察。Objective To analyze the dosimetric advantages of CT-guided interstitial brachytherapy for recurrent cervical cancer.MethodsA total of 16 patients with recurrent cervical cancer after radical surgery and adjuvant external beam radiotherapy received interstitial brachytherapy with CT-guided implantation of metal needles. The high-risk clinical target volume （HR-CTV） was given 36 Gy in 6 fractions. D90 for HR-CTV in the brachytherapy and the cumulative D2 cm3 values for the bladder, rectum, and sigmoid colon in the previous external beam radiotherapy and the brachytherapy were analyzed. ResultsThe mean D90 value for HR-CTV was 52.5±3.3 Gy. The cumulative D2 cm3 values for the bladder, rectum, and sigmoid colon were 85.6±5.8 Gy, 71.6±6.4 Gy, and 69.6±5.9 Gy, respectively. The mean number of metal needles was 6.1±1.5 in each brachytherapy. The actual 1-year overall survival and local control were 81% and 69%, respectively.ConclusionsCT-guided interstitial brachytherapy for recurrent cervical cancer shows good dose-volume histogram parameters and few complications, so it may be clinically feasible. However, its long-term clinical efficacy needs further observation.

关 键 词：宫颈肿瘤/组织间插植近距离疗法 剂量学 

分 类 号：R730.55[医药卫生—肿瘤]