口服泛影葡胺对宫颈癌容积旋转调强放疗剂量分布的影响  

Effects of oral diatrizoate on the dose distribution of volumetric modulated arc therapy for cervical cancer

作　　者：吴晓维 崔相利[1,2] WU Xiaowei;CUI Xiangli(Anhui Provincial Key Laboratory of Medical Physics and Technology,Center of Medical Physics and Technology,Hefei Institute of Physical Sciences,Chinese Academy of Sciences,Hefei 230031,China;Department of Radiation Oncology,Cancer Hospital,Chinese Academy of Sciences,Hefei 230031,China)

机构地区：[1]中国科学院合肥物质科学研究院/医学物理与技术中心/医学物理与技术安徽省重点实验室,安徽合肥230031 [2]中国科学院合肥肿瘤医院放疗中心,安徽合肥230031

出　　处：《中国医学物理学杂志》2019年第5期525-528,共4页Chinese Journal of Medical Physics

基　　金：安徽省公益性技术应用研究联动计划项目(1704f0804051);安徽省重点研究与开发计划项目(1804h08020279)

摘　　要：目的:探讨口服泛影葡胺溶液对宫颈癌容积旋转调强放疗剂量分布的影响。方法:选择12例口服泛影葡胺溶液的宫颈癌患者的CT图像,设计容积旋转调强放疗计划。采用相同CT图像,更改肠造影区CT值为常规肠内容物CT值,并保持其他参数不变,将VMAT计划移植到改变了CT值的CT图像上,重新计算剂量分布。借助肿瘤靶区和危及器官分析肠造影区CT值改变前后剂量分布的差异。结果:肠造影区CT值改变前后,计划靶区适形度和均匀度的比较显示差异无统计学意义(P>0.05);计划靶区最小和最大剂量相对百分比分别为0.07和0.15(P=0.32, 0.59),而平均剂量差异为0.09(P=0.00)。危及器官中仅肠的剂量分布有显著统计学差异,其V_(40)、V_(30)和V_(20)相对百分比分别为0.11、0.16和0.03(P=0.03, 0.03, P=0.03)。结论:口服泛影葡胺溶液对宫颈癌靶区的平均剂量及肠剂量分布的影响有显著统计学意义。但从临床分析结果来看,口服泛影葡胺溶液造成剂量分布的绝对差异可忽略。Objective To discuss the effects of oral diatrizoate on the dose distribution of volumetric modulated arc therapy (VMAT) for cervical cancer. Methods The CT images of 12 cervical cancer patients after taking oral diatrizoate were selected and VMAT (Plan A) was designed for each patient. Based on the same CT images, the CT value of contrast area in intestine was changed to the value of intestinal content, and the other parameters remained unchanged. The VMAT plan was transplanted on the CT image with the CT value of intestinal content (Plan B), and the dose distribution was re-calculated. The dosimetric differences were analyzed by assessing the deviation of dose distribution of target areas and organs-at-risk between PlanAand Plan B. Results Both Plan A and Plan B had similar conformity index and homogeneity index of target areas (P>0.05). The relative percentages of minimum dose, maximum dose and mean dose between Plan Aand Plan B was 0.07, 0.15 and 0.09, respectively (P=0.32, 0.59, 0.00). For the dosimetirc parameters of organs-at-risk, statistical differences were only found in intestine, and the relative percentage of the V40, V30 and V20 of intestine were 0.11, 0.16 and 0.03, respectively (P=0.03, 0.03, 0.03). Conclusion The effect of oral diatrizoate on dose distribution was statistically significant for both the mean dose of planning target areas and the dose distribution of intestine. However, the clinical analysis reveals that the absolute differences of dose distribution caused by oral diatrizoate can be neglected.

关 键 词：宫颈癌 容积旋转调强 口服泛影葡胺溶液 剂量分布 

分 类 号：R730.55[医药卫生—肿瘤]