中华放射医学与防护杂志

郑敏,王先良,王捷,等.宫颈癌后装放疗时膀胱直肠小肠受照剂量探讨[J].中华放射医学与防护杂志,2015,35(9):683-686.Zheng Min,Wang Xianliang,Wang Jie,et al.The analysis of exposure dose for bladder, rectum and small intestine with brachytherapy for cervical cancer[J].Chin J Radiol Med Prot,2015,35(9):683-686

宫颈癌后装放疗时膀胱直肠小肠受照剂量探讨

The analysis of exposure dose for bladder, rectum and small intestine with brachytherapy for cervical cancer

投稿时间：2015-02-02

DOI：10.3760/cma.j.issn.0254-5098.2015.09.010

中文关键词: 近距离放疗直肠膀胱小肠

英文关键词:Brachytherapy Rectum Bladder Small intestine

基金项目:

作者	单位	E-mail
郑敏	530021 南宁, 广西医科大学研究生学院
王先良	四川省肿瘤医院放疗科
王捷	四川省肿瘤医院放疗科	wxr792000@163.com
何玲	四川省疾病预防控制中心
谢非	530021 南宁, 广西医科大学研究生学院
袁珂	四川省肿瘤医院放疗科

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中文摘要:

目的探讨宫颈癌腔内放疗时不同体积的膀胱、直肠与危及器官受照剂量的关系。方法选取宫颈癌患者共47例,给予剂量点处方剂量600 cGy的高剂量率腔内后装治疗,用剂量体积直方图(DVH)评价标准计划下不同体积的膀胱、直肠和小肠对相应受照剂量的影响。将膀胱按体积大小分成<80 cm³组、80~120 cm³组和>120 cm³组,直肠按体积大小分成>60 cm³ 组和≤60 cm³组,分析其体积与剂量分布的关系。采用方差分析和t检验方法分析D_{1 cm³}、D_{2 cm³}、D_30%和D_50%。结果与膀胱体积<80 cm³组相比,80~120 cm³组和>120 cm³组的膀胱D_30%、D_50%受照剂量增高(F=5.074、5.088,P<0.05),小肠D_{1 cm³}和D_{2 cm³}值差异无统计学意义(P>0.05);与直肠体积>60 cm³ 组相比,≤60 cm³组的直肠D_{1 cm³}受照剂量减小(t=-2.045,P<0.05)。结论宫颈癌近距离放疗时,保持膀胱的适当充盈,直肠体积的减少,可使直肠、膀胱和小肠的受照射剂量均相对降低,从而减少放疗的不良反应。

英文摘要:

Objective To analyze the relationship between different rectal volume, bladder volume and dose of organs at risk (OARs) in intracavitary brachytherapy for cervical cancer. Methods A total of 47 patients with cervical cancer were selected. All of them were treated with high dose rate (HDR) intracavitary brachytherapy with a 600 cGy dose for the dosage point. The effects of different volume of rectum bladder and small intestine for corresponding exposure dose under the standard planning were evaluated using a dose-volume histogram (DVH). According to bladder volume, patients were divided into three groups,< 80 cm³ group, 80-120 cm³ group and > 120 cm³ group. And according to rectum volume, patients were divided into > 60 cm³ group and ≤ 60 cm³ group. The relationship between the volume and dosage were analyzed. The ANOVA test and t test were used for analyzing D_{1 cm³}, D_{2 cm³}, D_30% and D_50%. Results Compared with the group with< 80 cm³ bladder volume, D_30%, D_50% value of bladder in groups with 80-120 cm³ and > 120 cm³ of bladder volume increased (F=5.074, 5.088, P<0.05). The difference of D_{1 cm³} and D_{2 cm³} value of the small intestine between 80-120 cm³ and > 120 cm³ bladder volume groups were not statistically significant (P>0.05). D_{1 cm³} of rectum in groups with ≤ 60 cm³ rectum volume was decreased than that of > 60 cm³ group (t=-2.045, P<0.05). Conclusions Keeping an appropriatly full bladder and reducing rectal volume in cervical cancers treated with intracavitary brachytherapy can make the exposure dose of bladder, rectum and small intestine relatively small, and reduce the adverse reactions of radiotherapy.

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