宫颈癌患者术后伴发淋巴囊肿辅助放疗时不同靶区勾画的疗效及安全性分析  

Efficacy and Safety Analysis of Different Target Areas Outlined in Adjuvant Radiotherapy for Cervical Cancer Patients with Postoperative Lymphocysts

作　　者：章玲玲 胡本辉 刘雅雯 涂海燕[1] 李凌[1] ZHANG Lingling;HU Benhui;LIU Yawen(Jiangxi Maternal and Child Health Hospital,Nanchang,330006)

机构地区：[1]江西省妇幼保健院,330006

出　　处：《实用癌症杂志》2024年第9期1469-1472,共4页The Practical Journal of Cancer

基　　金：江西省卫生健康委科技计划(编号:202310962)。

摘　　要：目的探讨宫颈癌术后伴发淋巴囊肿给予辅助放疗时不同靶区勾画对淋巴囊肿的疗效及其安全性。方法选取宫颈癌术后伴发淋巴囊肿并具有放疗指征的患者79例,均应用调强放疗(IMRT)技术,根据临床靶区(CTV)勾画范围分对照组37例,观察组42例。对照组的CTV按指南规范勾画放疗靶区但未包全淋巴囊肿,观察组的CTV包全淋巴囊肿。评估两组膀胱、小肠、直肠放疗剂量体积,并观察相关的放射不良反应。放疗结束后评价两组患者淋巴囊肿放疗转归情况。结果两组淋巴囊肿体积无统计学差异(P>0.05),观察组CTV体积及淋巴囊肿照射剂量明显大于对照组,具有统计学差异(P<0.05);DVH图显示两组危及器官(膀胱、小肠、直肠)受照最大剂量DOSEmax无统计学差异(P>0.05),观察组膀胱、小肠、直肠V40大于对照组,具有统计学差异(P<0.05);观察组放射性膀胱炎、放射性肠炎及骨髓抑制发生率高于对照组,具有统计学差异(P<0.05);放疗结束后观察组、对照组患者总有效率分别为95.24%、91.89%,两组比较无统计学差异(P>0.05)。结论宫颈癌术后伴发淋巴囊肿需辅助放疗的患者,放疗可有效控制淋巴囊肿,即使部分包全淋巴囊肿,其所受照射剂量也较大,有效率较高,故临床靶区勾画时不需刻意包全淋巴囊肿,避免增加危及器官的受照体积,从而增加不良反应。Objective To investigate the efficacy and safety of different target delineation for lymphatic cysts associated with cervical cancer after operation and adjuvant radiotherapy.Methods A total of 79 patients with lymphocysts and radiotherapy indications after early cervical cancer surgery were selected.All patients were treated with intensity modulated radiotherapy(IMRT)technology and randomly divided into 2 groups according to the range of clinical target area(CTV).Among them,37 patients in the control group(CTV)delineated the radiotherapy target area according to the guideline specification but did not include lymphatic cysts,while 42 patients in the observation group(CTV)included lymphatic cysts.The dose volume of radiotherapy for bladder,small intestine and rectum was evaluated in the 2 groups,and the associated adverse effects were observed.The outcome of lymphatic cyst radiotherapy in the 2 groups was evaluated after radiotherapy.Results There was no statistical difference in the volume of lymphocysts between the 2 groups(P>0.05).The CTV volume and radiation dose of lymphocysts in the observation group were significantly higher than those in the control group(P<0.05);DVH showed that there was no statistical difference in the maximum dose DOSEmax of exposed organs(bladder,small intestine and rectum)between the 2 groups(P>0.05),and V40 of bladder,small intestine and rectum in the observation group was higher than that in the control group(P<0.05).The incidence of radiation cystitis,radiation enteritis and bone marrow suppression in observation group was higher than that in control group,with statistical difference(P<0.05).After radiotherapy,the total effective rate of the observation group and the control group was 95.24%and 91.89%,respectively,and there was no statistical difference between the 2 groups(P>0.05).Conclusion Radiotherapy can effectively control lymphatic cysts in patients with lymphatic cysts after cervical cancer surgery.Even if part of the lymphatic cysts are covered,the radiation dose is large

关 键 词：宫颈癌 淋巴囊肿 放射治疗 

分 类 号：R737.33[医药卫生—肿瘤]