近距离放疗中危及器官吸收剂量相关因素研究  

Study on related factors of absorbed dose in organs at risk during brachytherapy

作　　者：杨蕾 王有华 庞皓文 YANG Lei;WANG You-hua;PANG Hao-wen(Department of Radiation Oncology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Radiation Oncology,People's Hospital of Gulin County,Gulin 646500,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院肿瘤科,四川泸州646000 [2]古蔺县人民医院肿瘤科,四川古蔺646500

出　　处：《医疗卫生装备》2020年第10期43-46,共4页Chinese Medical Equipment Journal

摘　　要：目的:探求近距离放疗中危及器官(organ at risk,OAR)吸收剂量的相关因素,并建立相应的拟合公式,对近距离放疗计划进行质控。方法:选取西南医科大学附属医院肿瘤科宫颈癌与周围型肺癌接受近距离放疗的患者77例(宫颈癌50例、周围型肺癌27例)作为数据收集组,另选取宫颈癌与周围型肺癌接受近距离放疗的患者各10例作为数据验证组。分析数据收集组中与肺、膀胱、直肠、乙状结肠及小肠吸收剂量的相关因素,并建立拟合公式。通过数据验证组对拟合公式进行验证。结果:对于宫颈癌患者,膀胱、直肠、乙状结肠及小肠的D2 cm^3、D1 cm^3及D0.1 cm^3与高危临床靶区(high-risk clinical target volume,HR-CTV)外扩0.5 cm后和各危及器官的相交体积呈显著正相关(P<0.05);对于周围型肺癌患者,肺D1 000 cm^3、D1 500 cm^3与原发大体肿瘤体积(gross tumor volume,GTV)呈显著正相关(P<0.05);将相关数据进行拟合后建立了拟合公式。结论:该研究以宫颈癌与周围型肺癌为例,成功寻求出接受近距离放疗时危及器官吸收剂量的相关因素并建立相应的拟合公式,可在制订近距离放疗计划前预测各危及器官吸收剂量,对近距离放疗计划进行质控,减少主观因素影响。Objective To explore related factors of organ at risk(OAR)absorbed dose in brachytherapy and establish corres-ponding prediction formula to control the quality of brachytherapy plan.Methods Totally 77 patients(50 cervical cancer ones and 27 peripheral lung cancer ones)who received brachytherapy for cervical cancer and peripheral lung cancer at Department of Oncology,Southwest Medical University Hospital were selected into a data collection group,and 10 cervical cancer patients and 10 peripheral lung cancer patients who received brachytherapy were enrolled into a data validation group.Factors related to absorbed dose to the lung,bladder,rectum,sigmoid colon and small intestine were analyzed in the data collection group,and a fitting formula was established.The fit formula was validated by the data validation group.Results For the cervical cancer patients,D2cm,D1cnand D1cmof the bladder,rectum,sigmoid colon and small intestine were significantly correlated with the intersecting volume of each endangered organ after 0.5 cm of high-risk clinical target volume(HR-CTV)dilation(P<0.05);for the peripheral lung cancer patients,lung D1000cm and D1500cmwere significantly positively correlated with the primary gross tumor volume(GTV)(P<0.05);the fitting formula was established after fitting the correlation data.Conclusion Taking cervical cancer and lung cancer as examples,the relevant factors of patients receiving brachytherapy are successfully found out and the corresponding prediction model is established,which can predict the absorbed dose of each OAR before making the brachytherapy plan and execute quality control for brachytherapy plan to reduce the impact of subjective factors.[Chinese Medical Equipment Journal,2020,41(10):43-46]

关 键 词：近距离放疗 危及器官 吸收剂量 宫颈癌 肺癌 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]