经腹超声引导下宫颈癌三维腔内近距离放射治疗计划的剂量学分析  

Dosimetric analysis of the brachytherapy scheme of 3D intra cavity under the guidance with TAUS

作　　者：李云[1] 刘云聪[1] 王瑞芳[1] 冯志宇[1] 黎欢 俞婕[1] LI Yun;LIU Yun-cong;WANG Rui-fang(Department of Oncology,Guizhou Provincial People’s Hospital,Guiyang 550002,China;不详)

机构地区：[1]贵州省人民医院肿瘤科,贵州贵阳550002 [2]贵州省人民医院超声科,贵州贵阳550002

出　　处：《中国医学装备》2022年第12期15-20,共6页China Medical Equipment

基　　金：贵州省卫生健康委科学技术基金(gzwkj2022-027)“3D打印阴道施源器在子宫内膜癌、宫颈癌术后患者阴道近距离治疗中的应用”。

摘　　要：目的:探讨经腹超声检查(TAUS)引导施源器置入术的使用对中晚期宫颈癌患者放射治疗高剂量率三维腔内近距离治疗(3D-ICB)计划中剂量分布的影响。方法:选取已完成治疗的40例宫颈癌ⅡB(IIA2)~ⅣA期患者,根据腹部超声引导方法将其分为TAUS组和盲探组,每组20例,TAUS组采用TAUS引导宫腔内施源器置入,盲探组采用盲探法置入。两组共制定200次三维近距离治疗计划,统计两组90%靶区体积的受照剂量(D_(90)),膀胱、肠和直肠2 cc体积所受照剂量(D2cc),检验TAUS对两组计划统计结果的影响。结果:TAUS组和盲探组D_(90)高风险临床肿瘤体积(HR-CTV)分别为91.83 Gy和88.82 Gy,中风险临床肿瘤体积(IR-CTV)分别为77.11 Gy和75.03 Gy,低风险肿瘤临床体积(LR-CTV)分别为65.33 Gy和60.52 Gy,且TAUS组均高于盲探组,差异均有统计学意义(t=2.453,t=2.937,t=7.797;P<0.05);TAUS组和盲探组危及器官D2cc中膀胱分别为82.01 Gy和82.18 Gy,肠(小肠和乙状结肠)分别为79.53 Gy和83.17 Gy,直肠分别为72.11 Gy和74.05 Gy,且TAUS组均低于盲探组,差异均有统计学意义(t=-2.175,t=-5.287,t=-3.194;P<0.05)。结论:TAUS为中晚期尤其是大肿瘤宫颈癌患者放射治疗的3D-ICB计划提供了一个更精准、更安全的方法。Objective:To explore the effect of the application of the catheterization of applicator under the guidance with TAUS on dose distribution in three-dimensional intra cavity brachytherapy(3D-ICB)plan of high-dose-rate of radiotherapy on patients with cervical cancer at middle and advanced stage.Methods:40 patients with cervical cancer at stageⅡB(IIA2)-ⅣA who had completed therapy were selected.They were divided into TAUS group and blind detection group according to different abdomen ultrasound guidance method,with 20 cases in each group.TAUS group adopted guidance-TAUS intra cavity applicator to implement implantation,and blind detection group adopted blind detection method.Two groups formulated total of 2003D brachytherapy plans,and the exposure dose of 90%target volume(D_(90)),the exposure doses of 2cc volume(D2cc)of bladder,intestine and rectum of two groups were calculated as statistic method.The effects of TAUS on the statistical results of the plans of two groups were tested.Results:The D_(90)of high risk-clinical tumor volume(HR-CTV)of TAUS group and blind detection group were respectively 91.83 Gy and 88.82 Gy,and those of intermediate risk-clinical tumor volume(IR-CTV)of two groups were respectively 77.11 Gy and 75.03 Gy,and those of low risk-clinical tumor volume(LR-CTV)were respectively 65.33 Gy and 60.52 Gy,and those of TAUS group were significantly higher than them of blind detection group(t=2.453,t=2.937,t=7.797,P<0.05),respectively.The D2cc of the bladder of organs at risk(OAR)in TAUS group and blind detection group were respectively 82.01 Gy and 82.18 Gy,and those of the intestines of two groups were respectively 79.53 Gy and 83.17 Gy,and those of the rectums of two groups were respectively 72.11 Gy and 74.05 Gy,and those of TAUS group were significantly lower than them of blind detection group(t=-2.175,t=-5.287,t=-3.194,P<0.05),respectively.Conclusion:TAUS provides a more precise and safer method for 3D-ICB plan of patients with cervical cancer at middle and advanced stage,especially with large

关 键 词：宫颈癌 三维腔内近距离治疗(3D-ICB) 治疗计划 经腹超声(TAUS) 三维近距离放射治疗 

分 类 号：R737.33[医药卫生—肿瘤] R814.2[医药卫生—临床医学]