局部晚期宫颈癌CT引导组织间插植BT与腔内BT剂量学与近期疗效比较  

Dosimetry and short term effect comparison of CT-guided interstitial brachytherapy and intracavitary brachytherapy for locally advanced cervical cancer

作　　者：刘忠山[1] 郭杰[1] 赵杨祉[2] 林霞[1] 任晓俊[1] 王红勇[1] 邱玲[1] 李云峰[1] 王铁君[1] Liu Zhongshan;Guo Jie;Zhao Yangzhi;Lin Xia;Ren Xiaojun;Wang Hongyong;Qiu Ling;LiYunfeng;Wang Tieiun(Department of Radiation Oncology, Second Affiliated Hospital of Jilin University, Changchun 130041, China （Liu ZS, Guo J, Lin X, Ren X J, Wang HY, Qiu L, Li YF, Wang T J;Cancer Center, First AJfiliated Hospital of Jilin University, Changchun 130021, China （ Zhao YZ)

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6期588-592,共5页Chinese Journal of Radiation Oncology

摘　　要：探讨CT引导下组织间插植BT技术较传统腔内BT技术在局部晚期宫颈癌治疗中的剂量学优势,提供一种更加有利的临床治疗方法。方法 28例经过体外放疗后仍残留巨大肿块（肿瘤〉 5 cm）的局部晚期宫颈癌患者接受CT引导下的组织间插植BT。将该研究的剂量学结果,包括总剂量（体外放疗和BT）的HR-CTV D90和膀胱、直肠及乙状结肠的D2cc,与之前一组接受传统腔内BT （宫腔管＋卵圆体对）的30例患者进行比较分析。结果 HR-CTV D90的平均值在腔内BT组、组织间插植BT组分别为（76.9±5.7）、（88.1±3.3） Gy。膀胱、直肠、乙状结肠D2cc在腔内BT组和组织间插植BT组中分别为（84.7±6.8）、（69.2±4.2）、（67.8±4.5） Gy 和（81.8±6.5）、（66.8±4.0）、（64.8±4.1） Gy。1年LC率在腔内BT组和组织间插植BT组分别为59.3%和85.2%。结论 与传统腔内BT相比较,CT引导下组织间插植BT技术具有剂量学优势或许是临床可行的,但长期疗效和不良反应还需进一步评估。Objective To discuss the dosimetric advantage of computed tomography-guided interstitial brachytherapy compared with the conventional intracavitary brachytherapy for locally advanced cervical cancer,offering a more advantageous clinical treatment approach. Methods Twenty-eight locally advanced cervical cancer patients with bulky tumors （tumor size〉5 cm） after external beam radiotherapy received computed tomography-guided interstitial brachytherapy. Dosimetric outcomes of the current study,including the total dose （external beam radiotherapy＋ brachytherapy） D90 for the HR-CTV and D2cc for the bladder,rectum,and sigmoid,were compared with a former patient group consisting of 30 patients who received the conventional intracavitary brachytherapy （uterine tandem＋ ovoid pairs）. Results The mean D90 value for HR-CTV in the intracavitary brachytherapy group and interstitial brachytherapy group were （76.9±5.7） and （88.1±3.3） Gy,respectively. The D2cc for the bladder,rectum,and sigmoid in the intracavitary brachytherapy group and interstitial brachytherapy group were （84.7±6.8） Gy,（69.2±4.2） Gy,（67.8±4.5） Gy and （81.8±6.5） Gy,（6.8±4.0） Gy,（64.8±4.1） Gy,respectively.1-year local tumor control rate in the intracavitary brachytherapy group and interstitial brachytherapy group were 59.3% and 85.2%,respectively. Conclusions CT-guided interstitial brachytherapy shows a significant dosimetric advantage compared with the conventional intracavitary brachytherapy,and is,thereby,clinically possible feasible. However,the long term curative effect and toxicity need to be further investigated.

关 键 词：宫颈肿瘤/近距离疗法 近距离疗法 组织间捅植 近距离疗法 腔内 剂量学 

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