3D打印阴道模型塞应用在宫颈癌近距离治疗中的剂量学研究  

Dosimetric study on 3D-printing multi-channel applicator interstitial brachytherapy for cervical cancer

作　　者：陶娜[1] 安永伟[1] 欧阳水根[1] 罗莉[1] 孙晓燕 张春林[1] 魏玺仪[1] TAO Na;AN Yongwei;OUYANG Shuigen;LUO Li;SUN Xiaoyan;ZHANG Chunlin;WEI Xiyi(Department of Radiotherapy,Gansu Provincial Cancer Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院放疗科,兰州730050

出　　处：《辐射研究与辐射工艺学报》2020年第4期51-56,共6页Journal of Radiation Research and Radiation Processing

摘　　要：比较宫颈癌近距离治疗中肿块体积在50~90 cm^3之间,应用3D打印阴道模型塞插植治疗与常规三维腔内治疗的剂量学差异,研究3D打印阴道模型塞应用在大肿块宫颈癌近距离治疗中的可行性,为临床应用提供参考。收集甘肃省肿瘤医院放疗科2017年5月至2019年5月收治的宫颈癌患者行近距离放射治疗,肿块体积在50~90 cm^3之间的患者27例,其中14例患者在近距离治疗中行3D打印阴道模型塞插植治疗(3D printing interstitial BT,3DP-ISBT),另13例行常规三维腔内治疗(Intracavitary BT,ICBT)。在高危临床靶区(HR-CTV)处方剂量为6 Gy的情况下,评估HR-CTV体积大小,HR-CTV的D90(90%体积接收到的最低吸收剂量)、膀胱、直肠的剂量学差异。与ICBT组相比,3DP-ISBT组HR-CTV的体积及D90、直肠大于1 cm^3、2 cm^3、3 cm^3体积接收到的吸收剂量D1cc、D2cc和D3cc均无统计学差异(p>0.05)。膀胱的D1cc、D2cc和D3cc低于ICBT组,有统计学差异(p<0.05)。宫颈癌近距离治疗中肿块体积在50~90 cm3之间应用3DP-ISBT技术在剂量学上能够满足临床要求,与ICBT技术相比能更好地保护膀胱,在直肠的保护上未显示出优势。In this study,we aimed to determine the dosimetric differences between 3D-printing multi-channel applicator interstitial brachytherapy(3DP-ISBT)and conventional three-dimensional intracavity treatment(ICBT)for cervical cancer with a high-risk clinical target volume(HR-CTV)of 50~90 cm3,to determine the feasibility of using 3DP-ISBT,and to provide a basis for the application of 3DP-ISBT in clinical practice.The study included 27 patients with cervical cancer and an HR-CTV of 50~90 cm3 who underwent radiotherapy at Gansu Provincial Cancer Hospital between May 2017 and May 2019.Among them,14 patients were treated with 3DP-ISBT and 13 were treated with ICBT.With a prescription dose was 6 Gy,evaluated the volume of the HR-CTV,the dosimetric differences in D90(received absorbed dose of 90%of the HR-CTV)of the HR-CTV,bladder,and rectum.Compared with the ICBT group,the 3DP-ISBT group showed no statistical differences in volume of the HR-CTV,D90 of the HR-CTV,and D1cc,D2cc,and D3cc of the rectum(doses received by 1 cm^3,2 cm^3,and 3 cm3 of the rectal volume)(p>0.05).D1cc,D2cc,and D3cc of the bladder were lower in the 3DP-ISBT group than in the ICBT group,and the difference was statistically significant(p<0.05).3DP-ISBT for cervical cancer with an HR-CTV volume of 50~90 cm3 can meet clinical requirements.The target can be irradiated with a sufficient dose in large-volume cancer and can protect the bladder better than can ICBT,however,there are no advantages in terms of protection of the rectum.

关 键 词：宫颈癌 3D打印阴道模型塞 腔内治疗 剂量学 

分 类 号：R815[医药卫生—放射医学]