宫颈癌同步放化疗急性放射性肠炎的剂量学参数分析  

Analysis of dosimetric parameters of acute radiation enteritis in cervical cancer patients treated with con⁃current chemoradiotherapy

作　　者：胡静[1] 王旭[1] 龚筱钦 凌锐[1] 游涛[1] 戴春华[1] 田野[2] 陈飞[1] HU Jing;WANG Xu;GONG Xiaoqin;LING Rui;YOU Tao;DAI Chunhua;TIAN Ye;CHEN Fei(Department of Radiation Oncology,Affiliated Hospital of Jiangsu University,Zhenjiang 212000,China;不详)

机构地区：[1]江苏大学附属医院放疗科,江苏镇江212000 [2]苏州大学附属第二医院放疗科,江苏苏州215000

出　　处：《实用医学杂志》2024年第5期672-676,共5页The Journal of Practical Medicine

基　　金：江苏省自然科学基金项目(编号:BK20211124);江苏省镇江市重点研发计划(社会发展)(编号:SH2023002)。

摘　　要：目的 探索宫颈癌放疗患者肠道剂量与急性放射性肠炎(ARE)的相关性。方法 回顾性分析2014-2019年间158例宫颈癌同步放化疗患者的临床资料,根据CTCAE 5.0将ARE≥2级的患者归为ARE≥2级组,否则归为ARE <2级组。从剂量体积直方图中提取患者肠道剂量参数,采用单因素及多因素logistic回归分析ARE≥2级与肠道剂量学参数的相关性。结果 26例(16.46%)患者发生≥2级ARE。营养不良、三维适形放疗的患者ARE≥2级的发生率高于营养良好、调强放疗的患者(P <0.05);发生ARE≥2级的患者肠袋V5、V40和直肠V50高于ARE <2级的患者(P <0.05);ROC曲线显示肠袋V5和V40是ARE≥2级的显著预测因子(AUC> 0.7,P <0.05)。结论 宫颈癌同步放化疗的患者应考虑肠袋V5和V40剂量,合理优化放疗计划,以期降低ARE≥2级的发生率。Objective To explore the correlation between intestinal dose and acute radiation enteritis(ARE)in patients with cervical cancer received concurrent chemoradiotherapy,and optimize the dose limit of intestinal tissue.Methods 158 cervical cancer patients received concurrent chemoradiotherapy from 2014 to 2019 were selected in this study.According to CTCAE 5.0,patients with ARE≥grade 2 were classified as ARE≥grade 2 group,otherwise classified as ARE<grade 2 group.The intestinal dosimetric parameters of the two groups were recorded from the dose volume histogram.The correlation between ARE≥grade 2 and intestinal dosimetric param-eters were analyzed using univariate and multivariate logistic regression.Results Among the 158 cervical cancer patients received concurrent chemoradiotherapy,26 cases had grade 2 or above ARE(16.46%).The incidence of ARE≥grade 2 in patients with malnutrition and three-dimensional conformal radiotherapy was significantly higher than that in patients with well-nourished and intensity modulated radiotherapy(P<0.05).The bowelbag V5,V40 and the rectal V50 of cervical cancer patients with ARE≥grade 2 were significantly higher than those with ARE<grade 2(P<0.05).ROC curves showed that bowelbag V5 and V40 were significant predictors of ARE≥grade 2(AUC>0.7,P<0.05).Conclusions For patients with cervical cancer received concurrent chemoradiotherapy,the dose of bowelbag V5 and V40 should be considered to rationally optimize the dose of bowelbag in the radiotherapy plan,so as to reduce the incidence of ARE≥grade 2.

关 键 词：宫颈癌 同步放化疗 急性放射性肠炎 剂量学 

分 类 号：R815.6[医药卫生—放射医学]