碘-125粒子治疗复发宫颈鳞癌术后剂量参数与疗效关系分析  

The relationship between dose parameter and curative effect on recurrent cervical squamous cell carcinoma treated by ^(125)I seed

作　　者：赵金鑫[1] 于慧敏[1] 梁岩松 刘泽洲[1] 徐克 李慧娟 底学敏 高贞[1] 王娟[1] 张宏涛[1] ZHAO Jinxin;YU Huimin;LIANG Yansong;LIU Zezhou;XU ke;LI Huijuan;DI Xuemin;GAO Zhen;WANG Juan;ZHANG Hongtao(Hebei Radioactive Seeds Brachytherapy Medical Center,Hebei Radioactive Seeds Brachytherapy Institute,No.Department of On-cology,the Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省肿瘤放射性粒子植入诊疗中心、河北省放射性粒子近距离治疗研究所、河北省人民医院肿瘤一科,河北石家庄050051

出　　处：《医学影像学杂志》2023年第6期1062-1065,共4页Journal of Medical Imaging

基　　金：河北省医学适用技术跟踪项目(编号:GZ2021082)。

摘　　要：目的探讨复发宫颈鳞癌粒子植入术后剂量参数与肿瘤体积缩小比的关系,并得出能够预测疗效的最佳参数。方法选取粒子植入治疗的宫颈鳞癌患者26例,共30个病灶。所有患者术后即刻行剂量验证,得出术后D_(90)。术后规律随访,根据患者实际随访时的CT图像计算术后t时刻肿瘤体积缩小比(R_(t))、术后1个月肿瘤体积缩小比(R_(1))、初月实际吸收剂量(D_(1m))、初月疗效校正吸收剂量(D_(1e))、初月敏感性校正吸收剂量(D_(1s))。将术后D_(90)与R_(1)进行曲线拟合,将术后D_(90)、D_(1m)、D_(1e)、D_(1s)与Rt进行曲线拟合,寻找各参数与肿瘤体积缩小比的关联性。结果术后D_(90)、D_(1m)、D_(1e)、D_(1s)、Rt、R_(1)均数分别为(105.4±22.8)Gy、(30.9±7.4)Gy、(37.1±8.9)Gy、(37.8±11.6)Gy、(39.4±17.0)%、(20.4±12.0)%。术后D_(90)与R_(1),术后D_(90)、D_(1m)、D_(1e)、D_(1s)与Rt均呈函数关系,方程式分别为y=6.856×10^(-7)x^(3)-2.66×10^(-4)x^(2)+0.031x-0.879(R^(2)=0.139),y=1.573×10^(-6)x^(3)-4.47×10^(-4)x^(2)+0.045x-0.967(R^(2)=0.027)、y=7.11×10^(-5)x^(3)-0.07x^(2)+0.193x-1.402(R^(2)=0.043)、y=3.546×10^(-5)x^(3)-0.003x^(2)+0.108x-0.744(R^(2)=0.126)、y=1.022×10^(-5)x^(3)-0.001x^(2)+0.048x-0.275(R^(2)=0.243)。结论术后D_(90)、D_(1m)、D_(1e)、D_(1s)与术后肿瘤体积缩小比有一定的相关性,可用于预测复发宫颈鳞癌粒子植入患者的疗效。相比D_(90)和D_(1m),D_(1e)与D_(1s)预测疗效可能更准确。Objective To investigate the relationship between dose parameters and tumor volume reduction ratio after ^(125)I seed implantation forrecurrent cervical squamous cell carcinoma,and to obtain the better parameters to predict the curative effect.Methods 26 cervical squamous cell carcinoma patients with 30 lesions were studied retrospectively in our clinic.All patients underwent dose verification immediately after operation,and postoperative D_(90)(the minimum peripheral dose accepted by 90%target volume)was obtained.The patients were followed up regularly.According to the CT images during the actual followup,the tumor volume reduction ratio at the end of t months(R_(t)),the tumor volume reduction ratio 1 month after operation(R_(1)),the first month actual absorbed dose(D_(1m)),the first month efficacy corrected absorbed dose(D_(1e)),the first month sensitivity corrected absorbed dose(D_(1s))and the t months actual absorbed dose(D_(t))were calculated.Curve fitting was performed for postoperative D_(90) and R_(1),and curve fitting was performed for postoperative D_(90),D_(1m),D_(1e),D_(1s) and R_(t) to find the correlation between each parameter and tumor volume reduction ratio.Results The mean values of D_(90),D_(1m),D_(1e),D_(1s),R_(t),R_(1)were(105.4±22.8)Gy,(30.9±7.4)Gy,(37.1±8.9)Gy,(37.8±11.6)Gy,(39.4±17.0)%,(20.4±12.0)%.Postoperative D_(90) and R_(1),postoperative D_(90),D_(1m),D_(1e),D_(1s) and R_(t) all hadpositive relationship.The equations were as follows:y=6.856×10^(-7)x^(3)-2.66×10^(-4)x^(2)+0.031x-0.879(R^(2)=0.139),y=1.573×10^(-6)x^(3)-4.47×10^(-4)x^(2)+0.045x-0.967(R^(2)=0.027),y=7.11×10^(-5)x^(3)-0.07x^(2)+0.193x-1.402(R^(2)=0.043),y=3.546×10^(-5)x^(3)-0.003x^(2)+0.108x-0.744(R^(2)=0.126),y=1.022×10^(-5)x^(3)-0.001x^(2)+0.048x-0.275(R^(2)=0.243).Conclusion Postoperative D_(90),D_(1m),D_(1e) and D_(1s) are positively correlated with postoperative tumor volume reduction ratio,which can be used to predict the efficacy of primary recurrent cervical squamous cell carcinoma patients with partic

关 键 词：碘-125粒子 宫颈癌 剂量 疗效 近距离治疗 体层摄影术 X线计算机 

分 类 号：R737.33[医药卫生—肿瘤] R814.42[医药卫生—临床医学]