宫颈癌术后快速容积旋转调强与三维适形放疗剂量学比较及疗效观察  

Dosimetry and Efficacy Study of Rapid Arc and Three Dimensional Conformal Radiotherapy for Postoperative Cervical Cancer

作　　者：赵环宇[1] 时飞跃[1] 秦伟[1] 陈成[1] 陈丽丽[1] 茹正兴[1] 陈锦飞[1] ZHAO Huanyu;SHI Feiyue;QIN Wei;CHEN Cheng;CHEN Lili;RU Zhengxing;CHEN Jinfei(Department of Oncology,Nanjing First Hospital,Nanjing Medical University,Nanjing Jiangsu 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)肿瘤科,江苏南京210006

出　　处：《中国医疗设备》2018年第11期47-50,共4页China Medical Devices

摘　　要：目的比较宫颈癌术后快速容积旋转调强(Rapid Arc)和三维适形放疗(3D-CRT)的剂量学差异,观察Rapid Arc疗效。方法选取2012年5月至2016年12月我院宫颈癌术后患者20例,CT模拟定位,同一CT图像分别设计Rapid Arc计划与3D-CRT计划,靶区剂量45 Gy/25次,比较两种计划的剂量学差异。20例宫颈癌患者术后接受Rapid Arc治疗,45 Gy/25次,观察放疗反应及1年、2年和3年生存率。结果 Rapid Arc计划的D_(1%)、D_(99%)、平均剂量(D_(mean))、均匀指数(HI)、适形指数(CI)均优于3D-CRT计划,差异有统计学意义(P<0.01)。Rapid Arc计划危及器官剂量V_(30)、V_(40)和最大剂量(D_(max))、平均剂量(D_(mean))均低于3D-CRT计划,差异有统计学意义(P<0.01)。Rapid Arc组I-II度白细胞减少、I-II度放射性肠炎和I度放射性膀胱炎发生率分别为35%、15%和10%;1年、2年和3年生存率分别为100%、100%和85.7%。结论 Rapid Arc计划和3D-CRT计划均可满足宫颈癌术后放疗的剂量学要求。Rapid Arc计划有更好的靶区均匀性、适形性,可以更好地保护危及器官,且无严重不良反应,值得临床推广。Objective We aimed to compare the dosimetric differences between Rapid Arc and three dimensional conformal radiotherapy(3D-CRT)for postoperative cervical cancer,and observe the efficacy of Rapid Arc.Methods From May 2012 to December 2016,a total of 20 patients with postoperative cervical cancer in our hospital were recruited in this study.Rapid Arc and 3D-CRT plans were designed based on the CT images from the patients using Eclipse 8.6 treatment planning system.The target dose was 45 Gy/25 fractions and the dosimetric differences between two groups were compared.These 20 patients with cervical cancer were treated with Rapid Arc after surgery,and their side effects and 1,2,and 3-year survival rates were observed.Results The plan target volume(PTV)parameters,including D1%,D99%,Dmean,homogeneity index(HI)and conformal index(CI)of Rapid Arc plan were better than that of 3D-CRT plan(P<0.01).The V30,V40,Dmax and Dmean of organs at risk in Rapid Arc group were lower than that in 3D-CRT group(P<0.01).The incidences of I-II leukopenia,I-II radiation enteritis and I radiation cystitis in patients under Rapid Arc treatment were 35%,15%and 10%,respectively.The 1,2 and 3-year survival rates were 100%,100%and 85.7%,respectively.Conclusion Both Rapid Arc and 3D-CRT can meet the clinical dosimetric demands.Rapid Arc plan provides superior HI and CI and better protection for organs at risk,compared with 3D-CRT plan.Rapid Arc is a feasible solution for postoperative radiotherapy in cervical cancer patients.

关 键 词：宫颈癌 快速容积旋转调强放疗 三维适形放疗 剂量学 

分 类 号：R737.33[医药卫生—肿瘤]