浅论膀胱充盈情况对行放疗的宫颈癌术后患者小肠受照剂量的影响  

Discussion on the effect of bladder filling on the dose of small intestin e radiation in postoperative patients with cervical cancer undergoing radiotherapy

作　　者：刘阳 LIU Yang(Radiotherapy Department,Yibin First People’s Hospital,Yibin 644000)

机构地区：[1]宜宾市第一人民医院放疗科,四川宜宾644000

出　　处：《当代医药论丛》2022年第15期58-60,共3页

摘　　要：目的:探究膀胱充盈情况对行放射治疗的宫颈癌术后患者小肠受照剂量的影响。方法:选取2021年1月至2021年7月在宜宾市第一人民医院接受放射治疗的宫颈癌患者30例,根据放射治疗时膀胱充盈情况的不同将其分为空膀胱组(n=15)和满膀胱组(n=15)。在放射治疗期间通过进行模拟定位CT扫描及CBCT扫描来确定两组患者膀胱大小的变化情况,利用直线加速器自带TPS来计算评估其小肠受照剂量的变化情况。结果:空膀胱组患者与满膀胱组患者膀胱体积的平均数分别为61.27cc、215.87cc,中位数分别为60cc、209cc,标准差分别为17.47cc和40.87cc,组间差异有统计学意义(P<0.05)。空膀胱组患者膀胱绝对体积的标准差明显小于满膀胱组患者,差异有统计学意义(P<0.05)。进行线性回归分析的结果显示,两组患者的膀胱绝对体积与其标准差之间具有一定的相关性(y=0.1612x+6.8475,r=0.9490)。应用TPS对模拟定位CT扫描和CBCT扫描的图像资料进行模拟计算的结果显示,两组患者治疗计划中小肠V45的平均体积(空膀胱组患者与满膀胱组患者小肠V45的平均体积分别为192cc和136cc)相比,差异有统计学意义(P<0.05);两组患者的膀胱体积与小肠受照剂量呈正相关。结论:膀胱充盈情况对行放射治疗宫颈癌术后患者的小肠受照剂量存在显著的影响。Objective:To investigate the effect of bladder filling on the dose of small intestine radiation in postoperative patients with cervical cancer undergoing radiotherapy.Methods:Thirty patients with cervical cancer who received radiotherapy in The First People’s Hospital of Yibin city from January 2021 to July 2021 were selected and divided into empty bladder group(n=15)and full bladder group(n=15)according to different bladder filling conditions during radiotherapy.During radiotherapy,simulated positioning CT scan and CBCT scan were carried out to determine changes in bladder size of patients in the two groups,and TPS of the linear accelerator was used to calculate and evaluate changes in the dose of small intestine exposure.Results:the mean bladder volume of patients with empty bladder and full bladder were 61.27cc and 215.87cc,the median was 60cc and 209cc,and the standard deviation was 17.47cc and 40.87cc,respectively,with statistical significance(P<0.05).The standard deviation of bladder absolute volume in empty bladder group was significantly lower than that in full bladder group,and the difference was statistically significant(P<0.05).The results of linear regression analysis showed that there was a certain correlation between the bladder absolute volume and its standard deviation(Y=0.1612x+6.8475,r=0.9490).TPS was used to simulate the image data of simulated positioning CT scan and CBCT scan,and the results showed that the mean volume of V45 in small intestine in the treatment plan of the two groups(the mean volume of V45 in the empty bladder group and the full bladder group were 192cc and 136cc,respectively)was statistically significant(P<0.05).There was a positive correlation between bladder volume and small intestine dose in both groups.Conclusion:Bladder filling has significant influence on the dose of small intestine radiation in patients after radiotherapy for cervical cancer.

关 键 词：宫颈癌 CBCT 膀胱充盈 小肠受照剂量 

分 类 号：R711[医药卫生—妇产科学]