经腹联合经直肠超声引导在宫颈癌组织间插植治疗中的应用研究  

Application of transabdominal combined transrectal ultrasound guidance in interstitial brachytherapy of cervical cancer

作　　者：赵环宇 李丽[2] 徐春霞[2] 陈茀[2] 白雪莲[3] ZHAO Huanyu;LI Li;XU Chunxia;CHEN Fu;BAI Xuelian(Baotou Medical College Center Clinical School of Medicine,Baotou,Imner Mongolia 014040,China;Department of Ultrasound,Baotou Central Hospital,Baotou,Imner Mongolia 014040,China;Department of Oncology,Baotou Central Hospital,Baotou,Inner Mongolia 014040,China)

机构地区：[1]包头医学院中心临床医学院,内蒙古包头014040 [2]包头市中心医院超声科,内蒙古包头014040 [3]包头市中心医院肿瘤科,内蒙古包头014040

出　　处：《影像研究与医学应用》2022年第23期20-22,26,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:评价超声引导在宫颈癌患者组织间插植治疗中的意义,并探讨经腹联合经直肠超声引导的应用价值。方法:选取2018年1月-2021年1月在包头市中心医院肿瘤科接受组织间插植治疗的宫颈癌患者53例,根据病人情况及插植针植入方式的不同,将患者分为A组(n=18)、B组(n=18)、C组(n=17),三组患者分别采用经腹联合经直肠超声引导,经腹超声引导和在CT下定位,比较三组高危靶区及周围器官的辐射剂量以及治疗期间和治疗后3~6个月内急性放射反应的发生情况。结果:在受照剂量方面,A组、B组HR-CTV D90、D100值均大于C组,差异有统计学意义(F=9.837、3.873,P <0.05),A组HR-CTV D90值大于B组,差异有统计学意义(P <0.05),A组、B组直肠及膀胱D2cc值均小于C组,差异有统计学意义(F=12.778、14.913,P <0.05),A组直肠D2cc值显著大于B组(P <0.05)。C组急性放射反应的发生率高于A、B两组,差异有统计学意义(χ^(2)=9.115,P <0.05)。结论:超声引导在宫颈癌组织间插植治疗中具有重要作用。并且经腹联合经直肠超声引导在优化剂量分布方面作用似乎更加明显,在靶区接受高剂量照射的同时,更好地保护了周围的危险器官。Objective To evaluate the importance of ultrasound guidance in interstitial brachytherapy in patients with cervical cancer,and to explore the application value of transabdominal combined transrectal ultrasound guidance.Methods 53 cervical cancer patients who received interstitial implantation therapy in the oncology department of Baotou Central Hospital from January 2018 to January 2021 were selected,the patients were divided into group A(n=18),group B(n=18),and group C(n=17)according to the patient’s condition and the different implantation methods of the insertion needle,the three groups of patients were respectively guided by transabdominal ultrasound combined with transrectal ultrasound,guided by transabdominal ultrasound,and positioned under CT.Compare the radiation doses of the three groups of high-risk target areas and surrounding organs and the occurrence of acute radiation reactions during treatment and within 3-6 months after treatment.Results In terms of irradiation dose,the HR-CTV D90 and D100values of group A and group B were higher than those in Group C,with statistically significant differences(F=9.837,3.873,P<0.05),and the HR-CTV D90 value of group A was greater than group B,with statistically significant difference(P<0.05).The D2cc values of rectum and bladder in group A and group B were lower than group C,with statistically significant difference(F=12.778,14.913,P<0.05),and the rectal D2cc value of group A was significantly greater than group B(P<0.05).The incidence of acute radiation reaction in group C was higher than that of groups A and B,with statistically significant differences(χ^(2)=9.115,P<0.05).Conclusion Ultrasound guidance plays an important role in the interstitial brachytherapy of cervical cancer.And transabdominal combined transrectal ultrasound guidance seems to be more effective in optimizing dose distribution,and while the target area receives high-dose irradiation,it better protects organs at risk.

关 键 词：宫颈癌 组织间插植治疗 经腹联合经直肠超声 经腹超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]