超声图像引导在宫颈癌放射治疗中的应用价值  

Application value of ultrasonic image guidance in radiotherapy of cervical cancer

作　　者：麻亚茹 刘金迪[1] 王亚娟 欧阳翼[1] 杨鑫[1] 姜晓勃[1] 林承光[1] 迟锋[1] MA Ya-Ru;LIU Jin-Di;WANG Ya-Juan(Department of Radiotherapy,Cancer Prevention Center,Sun Yat-sen University,Guangzhou,Guangdong 510060,China)

机构地区：[1]中山大学肿瘤防治中心放疗科,广东广州510060

出　　处：《中国妇幼保健》2022年第4期749-751,共3页Maternal and Child Health Care of China

基　　金：广东省医学科研基金项目(A2020516)。

摘　　要：目的分析超声图像引导在宫颈癌放射治疗中的应用价值。方法选取2017年12月—2019年5月中山大学肿瘤防治中心放疗科收治的34例宫颈癌患者,根据宫颈癌FIGO分期法分为A组和B组,每组17例。两组宫颈癌患者在每次放疗前行超声引导和锥形束CT(CBCT)扫描,获得X轴(左右)、Y轴(上下)、Z轴(前后)3个方向的摆位误差并进行分析。结果A组患者超声图像引导与CBCT的摆位误差在X轴分别为(-0.93±4.80)mm和(0.49±3.34)mm,差异有统计学意义(t=6.667,P<0.001),Z轴分别为(1.02±8.05)mm和(-0.11±2.91)mm,差异有统计学意义(t=-2.869,P=0.004)。B组患者超声图像引导与CBCT的摆位误差在X轴分别为(-0.25±4.49)mm和(0.10±3.96)mm,差异无统计学意义(t=1.778,P=0.076),Y轴分别为(1.12±7.75)mm和(0.41±6.28)mm,差异无统计学意义(t=-1.690,P=0.092),Z轴分别为(-0.01±7.24)mm和(0.32±4.40)mm,差异无统计学意义(t=1.078,P=0.282)。结论有淋巴结转移的中晚期宫颈癌患者放射治疗中,CBCT对盆腔淋巴转移区的图像校准有优势;对于早期宫颈癌患者,超声图像引导可替代CBCT应用于临床个体化精准放疗。Objective To analyze the application value of ultrasonic image guidance in radiotherapy of cervical cancer.Methods From December 2017 to May 2019,34 cervical cancer patients treated in Department of Radiotherapy,Cancer Prevention Center,Sun Yat-sen University were selected and divided into A group and B group according to FIGO cervical cancer staging method,17 cases in each group.Before radiotherapy,ultrasonic image guidance and cone beam computed tomography(CBCT)were performed in the two groups to obtain setup errors of X-axis(left-right),Y-axis(superior-inferior),and Z-axis(anterior-posterior).Results In A group,the setup errors of X-axis of ultrasonic image guidance and CBCT were(-0.93±4.80)mm and(0.49±3.34)mm,respectively,there was statistically significant difference(t=6.667,P<0.001);the setup errors of Z-axis were(1.02±8.05)mm and(-0.11±2.91)mm,respectively,there was statistically significant difference(t=-2.869,P=0.004).In B group,the setup errors of X-axis of ultrasonic image guidance and CBCT were(-0.25±4.49)mm and(0.10±3.96)mm,respectively,there was no statistically significant difference(t=1.778,P=0.076);the setup errors of Y-axis were(1.12±7.75)mm and(0.41±6.28)mm,respectively,there was no statistically significant difference(t=-1.690,P=0.092);the setup errors of Z-axis were(-0.01±7.24)mm and(0.32±4.40)mm,respectively,there was no statistically significant difference(t=1.078,P=0.282).Conclusion In radiotherapy of advanced cervical cancer with lymph node metastasis,CBCT has advantages for image calibration of area of pelvic lymph node metastasis;for the patients with early cervical cancer,ultrasonic image guidance can be used for clinical individualized precision radiotherapy instead of CBCT.

关 键 词：超声图像引导 摆位误差 宫颈癌 放射治疗 

分 类 号：R737.33[医药卫生—肿瘤]