| 朱雅迪,吴爱林,刘云琴,薛旭东,张朋,吴爱东.三种局部补量技术在晚期宫颈癌放疗中的应用研究[J].中华放射医学与防护杂志,2020,40(4):296-301 |
| 三种局部补量技术在晚期宫颈癌放疗中的应用研究 |
| Application of three different kinds of local boost techniques in radiotherapy for locally advanced cervical cancer |
| 投稿时间：2019-05-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.04.009 |
| 中文关键词: 局部晚期宫颈癌 近距离放疗 适形调强放射治疗 腔内/组织间插植 剂量学 |
| 英文关键词:Locally advanced cervical cancer Brachytherapy Intensity modulated radiotherapy Intracavitary/interstitial brachytherapy Dosimetry |
| 基金项目:国家自然科学基金（11805198）；安徽省自然科学基金青年项目（1808085QH281） |
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| 中文摘要: |
| 目的 探讨三维腔内联合组织间插植（IC/IS BT）、三维腔内（ICBT）联合调强 （ICBT+IMRT）以及单纯IMRT技术在局部晚期宫颈癌治疗中的剂量学差异。方法 选取16例接受三维近距离治疗的局部晚期宫颈癌患者，在原IC/IS BT计划的基础上分别设计ICBT+IMRT和单纯 IMRT计划，研究3种计划中肿瘤靶区和危及器官（OARs）的剂量学差异。结果 共制定75个后装治疗计划，其中IC/IS BT、ICBT+IMRT和单纯 IMRT各25个。 ICBT+IMRT与IC/IS BT计划的靶区体积剂量D90差异无统计学意义（P>0.05）， OARs的剂量比较低。单纯IMRT计划中OARs受量相对较大，且V60明显偏高（与IC/IS BT相比，t=6.77、10.37、4.61、2.83，P<0.05）。结论 ICBT+IMRT计划的肿瘤靶区剂量覆盖较好且OARs受剂量低，可以作为IC/IS BT替代治疗手段。单纯 IMRT技术虽然靶区覆盖度较好，但OARs保护差，不适用于晚期宫颈癌的局部补量治疗。 |
| 英文摘要: |
| Objective To investigate the dosimetry differences in the treatment of locally advanced cervical cancer with intracavitary/interstitial brachytherapy (IC/IS BT), intracavity brachytherapy combined with intensity modulated radiotherapy (ICBT+IMRT) and simple IMRT. Methods Totally 16 patients with local advanced cervical cancer were retrospectively selected, which were treated by three-dimensional brachytherapy. On the basis of the original three-dimensional intracavitary/interstitial brachytherapy plan, ICBT+IMRT and IMRT plans were designed respectively to study the dosimetry differences of target and different organs at risk for the three kinds of plans. Results A total of 75 brachytherapy treatment plans were designed, including 25 IC/IS BT, 25 ICBT+IMRT and 25 IMRT. There was not statistically significant difference of target dose parameters between ICBT+IMRT and IC/IS BT plan (P>0.05). ICBT+IMRT plans had better OAR sparing than IC/IS BT. The doses of OARs in the IMRT plans were relatively large and the volume irradiated to more than 60 Gy (V60) was significantly higher(t=6.77,10.37,4.61,2.83,P<0.05). Conclusions The ICBT+IMRT technique not only provides better target coverage, but also maintains low doses to the OARS, which can be used as an alternative treatment to IC/IS BT. Although the target coverage of IMRT is better, the protection of OARs is not satisfied, so it is not suitable for local boost therapy of advanced cervical cancer. |
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