CT引导下的两种插植技术在宫颈癌近距离放射治疗中的应用价值  

The Application Value of Two Implantation Techniques with CT Guidance in Brachytherapy of Cervical Cancer

作　　者：张婷 邱凌平[1] 李克[1] 殷皓泽 彭绿英 曾超 李丹[1] 田秋红[1] Zhang Ting;Qiu Lingping;Li Ke;Yin Haoze;Peng Lvying;Zeng Chao;Li Dan;Tian Qiuhong(The First Affiliated Hospital of Nanchang University,Nanchang Jiangxi 310000,China)

机构地区：[1]南昌大学第一附属医院,江西南昌310000

出　　处：《医疗装备》2024年第21期9-12,18,共5页Medical Equipment

基　　金：江西省教育厅科学技术研究青年项目(GJJ2200211)。

摘　　要：目的探讨CT引导下的2种插植技术在宫颈癌近距离放射治疗中的应用价值。方法选取2023年1—12月于医院接受近距离放射治疗的65例宫颈癌患者作为研究对象,根据插植方式不同分为塞子引导组(31例)与徒手插植组(34例)。塞子引导组采用3D打印塞子辅助引导插植,徒手插植组采用徒手插植。比较两组的高危临床靶区(HR-CTV)体积、HR-CTV的90%和98%体积受照射剂量D90%和D98%、HR-CTV的适形性指数(CI)及重要危及器官(OARs,包括膀胱、直肠、乙状结肠)的0.1%、1%、2%体积受照射剂量D0.1%、D1%、D2%。结果塞子引导组的HR-CTV体积为(54.9±26.9)cm^(3),小于徒手插植组的(69.9±44.8)cm^(3),差异有统计学意义(P<0.05);塞子引导组HR-CTV的D90%和D98%分别为(6.02±0.65)Gy、(5.14±0.37)Gy,均低于徒手插植组的(6.20±0.76)Gy、(5.26±0.54)Gy,差异有统计学意义(P<0.05);塞子引导组HR-CTV的CI为(0.81±0.04),高于徒手插植组的(0.76±0.06),差异有统计学意义(P<0.05);塞子引导组的膀胱和直肠D0.1%、D1%、D2%均低于徒手插植组,差异有统计学意义(P<0.05);两组的乙状结肠D0.1%、D1%、D2%比较,差异无统计学意义(P>0.05)。结论与徒手插植相比,3D打印塞子辅助引导插植可优化宫颈癌近距离放射治疗患者的靶区三维适形度,降低重要OARs的受照射剂量。Objective To explore the application value of two implantation techniques with CT guidance in brachytherapy for cervical cancer.Methods With the selection of sixty five cervical cancer patients who received brachytherapy in hospitals from January to December 2023 as the research subjects,they were divided into the template guidance group(31 cases)and the manual implantation group(34 cases),according to different implantation methods.With the use of 3D printed template to assist in guiding implantation in the template guidance group,and manual implantation in the manual implantation group,the high-risk clinical target volume(HR-CTV),90%and 98%volume of HR-CTV irradiated doses D90%and D98%,conformity index(CI)of HR-CTV,and 0.1%,1%,and 2%volume of important organs at risk(OARs,including bladder,rectum,and sigmoid colon)irradiated doses D0.1%、D1%、D2%were compared between the two groups.Results The HR-CTV volume of the template guidance group was(54.9±26.9)cm^(3),which was smaller than that of the manual implantation group(69.9±44.8)cm^(3),and the difference was statistically significant(P<0.05);The D90%and D98%of HR-CTV in the template guidance group were(6.02±0.65)Gy and(5.14±0.37)Gy,respectively,which were lower than those in the manual implantation group(6.20±0.76)Gy and(5.26±0.54)Gy,and the differences were statistically significant(P<0.05);The CI of HR-CTV in the template guidance group was(0.81±0.04),which was higher than that in the manual implantation group(0.76±0.06),and the difference was statistically significant(P<0.05);The D0.1%,D1%,and D2%for the bladder and rectum in the template guidance group were lower than those in the manual implantation group,and the differences were statistically significant(P<0.05);There was no statistically significant difference in the D0.1%,D1%,and D2%for the sigmoid colon between the two groups(P>0.05).Conclusion Compared with manual implantation,the use of 3D-printed template to assist in guiding implantation can optimize the three-dimensional conformity of the

关 键 词：3D打印塞子辅助引导插植 徒手插植 宫颈癌 近距离放射治疗 

分 类 号：R737.33[医药卫生—肿瘤]