宫颈癌放疗中膀胱充盈程度对靶区位置的影响  

Effect of Bladder Filling Degree on Target Location in Radiotherapy of Cervical Cancer

作　　者：赵静[1,2] 叶书成[2] 刘孝伟[2] 乔柱[2] 陈长建[2] 马守印[2] 程淑媛 李建彬 ZHAO Jing(School of Life Science of Shandong Academy of Medical Sciences Jinan University, Shandong Ji'nan 250200,China)

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,山东济南250200 [2]济宁医学院附属医院,山东济宁272029 [3]山东大学附属山东省肿瘤医院放疗科,山东济南250117

出　　处：《河北医学》2018年第7期1068-1072,共5页Hebei Medicine

基　　金：山东省自然科学基金;(编号:ZR2016HL103)

摘　　要：目的:探讨宫颈癌患者放疗中不同膀胱充盈程度对靶区位置的影响,为临床应用提供参考。方法:收集我院2016年6月至2017年6月ⅡB期一ⅢB期初治宫颈癌患者8例,CT定位时分别在膀胱充盈,半充盈和空虚状态下行CT扫描,分析宫颈及宫底在膀胱不同充盈状态下的移动幅度。结果:宫颈及宫底在膀胱不同充盈状态下会导致相对骨性标志的相对位移。其中左右方向变化最小,宫体病变最大幅度为1.5mm;在前胸后背方向其变化大,随着膀胱容量的增加宫颈病变大致向身体的背侧运动,最大幅度为19mm;在头脚方向膀胱在充盈程度和半充盈程度的宫颈病变的动度有统计学意义(P<0.05),在半充盈程度和空虚程度的宫颈病变的动度有统计学意义(P<0.05),而且随着膀胱充盈程度的增加,宫颈病变大致向身体的脚方向位移,最大幅度为18.6mm。对宫体的动度的影响在前胸后背相对较大,随着膀胱充盈程度的增加,宫体大致向身体的背侧运动,最大幅度为21mm,不同的膀胱充盈程度在头脚方向对宫体的动度有明显影响,而且随着膀胱充盈程度的增加,宫体大致向身体的头方向位移,最大幅度为13mm。结论:对宫颈癌患者进行放疗时需考虑膀胱不同充盈程度对宫颈及宫体位置移动,以减少靶区偏移,对正常组织起保护作用。Objective:To explore the effect of different bladder filling degree on target location in radiotherapy of cervical cancer patients,and to provide reference for clinical application.Methods:A total of 8 patients with cervical cancer who were treated in the first phase of IIB IIIB in our hospital from June 2016 to June 2017 were collected.CT scan was performed in the bladder filling,half filling and vacuity state respectively,and the location of the target area in the different filling states of the cervix and uterus was analyzed.Results:The relative displacement of cervix and uterus in the different filling state of the bladder chould lead to relative bone signs.The change of left and right direction was the smallest.The largest lesion of cervical lesion was 1.5mm.It changed greatly in the direction behind chest.With the increase of bladder capacity,the cervical lesions moved towards the back of the body.The maximum range was 19mm.In the head foot direction during bladder filling degree and half filling degree of the movement of the cervical lesions was statistically significant(P<0.05),at half filling degree and the degree of cervical lesions empty mobility was statistically significant(P<0.05),and with the increase of bladder filling degree of cervical lesions generally to the foot direction body displacement,maximum the amplitude of 18.6mm.The palace of the movement of the influence in the chest behind the relatively large,with the increase of bladder filling degree,the palace body generally to the dorsal movement of the body,the maximum amplitude was 21mm,relatively small in the direction of change,the maximum amplitude of 1.2mm and different degree of bladder filling in the head foot direction opposite to the movement of a body significantly,and increase with the degree of bladder filling,the palace body generally to the head direction of the body displacement,the maximum amplitude of 13mm.Conclusion:In the radiotherapy of cervical cancer,we need to consider the different degree of bladder filling to move the

关 键 词：宫颈癌 膀胱 充盈程度 靶区位置 

分 类 号：R737.33[医药卫生—肿瘤]