剂量学参数对CT引导^125I放射性粒子植入治疗放疗后盆腔复发宫颈癌疗效的影响  

Efficacy and dosimetric analysis of ^125I seeds implantation for pelvic recurrent cervical cancer after radiotherapy under CT guidance

作　　者：曲昂[1] 孙海涛[1] 姜伟娟[1] 江萍[1] 姜玉良[1] 李卫燕[1] 田素青[1] 王俊杰[1] Qu Ang;Sun Haitao;Jiang Weijuan;Jiang Ping;Jiang Yuliang;Li Weiyan;Tian Suqing;Wang Junjie(Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院肿瘤放疗科,100191

出　　处：《中华医学杂志》2018年第37期3014-3016,共3页National Medical Journal of China

摘　　要：目的探讨CT引导^125I放射性粒子植入治疗放疔后盆腔复发宫颈癌患者的剂量学因素对疗效的影响。方法回顾性分析北京大学第三医院接受CT引导^125I放射性粒子植入治疗的30例放疗后盆腔复发宫颈癌患者，中位年龄43．5（30-75）岁。通过术后计划评估剂量学参数。采用Kaplan-Meier法计算局部无进展生存率（LPFS）和总生存率（OS），并采用Log-rank检验、Cox回归进行单因素和多因素分析。结果1年和2年LPFS率分别为39．4％、22．5％。1年和2年OS率分别为57．3％、27．4％。术后计划，90％、100％大体肿瘤靶区（GTV）接受的剂量（D90和D100）分别为（132±47）和（51±24）Gy。接受100％、150％、200％的处方剂量的靶区体积百分比（V100、V150和V200）分别为88％±10％、69％±15％和51％±18％。D90≥105Gy或D100／〉55Gy或V100≥91％，LPFS明显延长（均P〈0．05）。D100是影响LPFS的独立因素。但剂量学参数对OS均无影响（均P〉0．05）。结论CT引导下^125I放射性粒子植入治疗放疗后盆腔复发宫颈癌，当D90≥105Gy或D100≥55Gy或V100≥91％时可延长LPFS，D100是影响LPFS的独立因素。Objective To evaluate the relationship of dosimetry parameters and efficacy of ^125I seeds implantation for pelvic recurrent cervical cancer （ PRCC ） after external beam radiotherapy （EBRT） under CT guidance. Methods A retrospective analysis was made on 30 PRCC patients after EBRT in Peking University Third Hospital with ^125I seeds implantation under CT guidance. Postoperative plans were made to evaluate the dosimetric parameters. Kaplan-Meier method was used to calculate local progression free survival （LPFS） rate and overall survival （OS） rate, and Log-rank test and Cox regression were used for univariate and muhivariate analysis. Results The 1-year and 2-year LPFS rate was 39.4% and 22. 5% , respectively. The 1-year and 2-year OS rate was 57.3% and 27.4% , respectively. On postoperative plan, D90 was （132 ±47） Gy, D100 was （51 ±24） Gy, V100 was 88% ±10% , V150 was 69% ± 15% , V200 was 51% ±8%.LPFS time would be longer while D90≥105 Gy or D100≥ 55 Gy or Y100≥ 91% （allP〈 0. 05）. D100 was significantly related to LPFS （P 〈0. 05）. But these dosimetry parameters got no effect on OS. Conclusions LPFS time of ^125I seeds implantation for PRCC after EBRT under CT guidance would be longer when D90 ≥ 105 Gy or D100≥ 55 Gy, or V100≥ 91%. D100 is an independent factor related to LPFS.

关 键 词：体层摄影术 X线计算机 放射治疗剂量 宫颈肿瘤 

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