| 郭昌,吴一凡,翟振宇,徐寒子.宫颈癌卵巢移位术后VMAT与IMRT卵巢放疗剂量的比较[J].中华放射医学与防护杂志,2021,41(5):334-339 |
| 宫颈癌卵巢移位术后VMAT与IMRT卵巢放疗剂量的比较 |
| Comparison of the ovarian sparing between VMAT and IMRT after ovarian transposition surgery for cervical cancer patients |
| 投稿时间：2020-09-07 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.05.003 |
| 中文关键词: 宫颈癌 卵巢移位手术 调强放射治疗 卵巢 剂量 |
| 英文关键词:Cervical cancer Ovarian transposition Intensity modulated radiotherapy Ovarian Dose |
| 基金项目:江苏省妇幼健康科研项目（F201762） |
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| 摘要点击次数: 2013 |
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| 中文摘要: |
| 目的 比较行卵巢移位术后的宫颈癌患者固定野调强（IMRT）和容积旋转调强（VMAT）计划中卵巢的剂量学差异。方法 31例接受宫颈癌根治术和卵巢移位术，术后需放射治疗的患者，设计9野均分IMRT计划和双弧VMAT计划，在保证靶区处方剂量及危及器官限量的情况下，尽量降低卵巢剂量。分析两种技术卵巢平均剂量的差异，以及卵巢-靶区间的位置与卵巢剂量间的关系。结果 31例患者中共有54个卵巢进行了有效的移位（移至靶区外）。其中9个卵巢位于宫颈癌靶区上边界以上即射野外，IMRT和VMAT的卵巢平均剂量分别为（177.8±90.7）和（166.7±70.6） cGy，差异无统计学意义（P>0.05）。45个卵巢与靶区处于相同的层面，IMRT和VMAT的卵巢平均剂量为（459.1±239.9）和（428.3±238.2） cGy （z=3.11，P=0.002）；卵巢平均剂量与卵巢体心到靶区最近距离高度负相关（IMRT：r=-0.922，P=0.001；VMAT：r=-0.865，P=0.001）；为将卵巢平均剂量降低至500 cGy，IMRT与VMAT计划中卵巢体心到靶区最近距离应分别大于3.6和3.3 cm。结论 卵巢位于靶区上边界以上时IMRT与VMAT卵巢剂量无差异；卵巢与靶区处于相同层面时，VMAT计划对于卵巢剂量和治疗效率上均优于IMRT；卵巢剂量可通过卵巢体心到靶区的最近距离预测。 |
| 英文摘要: |
| Objective To compare the dosimetric difference between IMRT and VMAT plans for ovarian protection after cervical cancer ovarian transposition surgery. Methods Thirty-one patients who had received both cervical cancer resection and ovarian transposition were selected for adjuvant radiotherapy. The 9-field evenly divided IMRT and the dual-arc VMAT technology were performed for the treatment planning. The difference of the ovarian mean dose between the two techniques was explored. The relationship between the position of the ovarian-target interval and the ovarian dose was also analyzed. Results A total of 54 ovaries in 31 patients were effectively transposed and moved out of the target area. Among them, 9 ovaries were located above the upper boundary of the PTV. For these cases, the ovarian mean dose of IMRT and VMAT were (177.8±90.7) and (166.7±70.6) cGy, respectively, which was not statistically different(P>0.05).45 ovaries were located in the same level with PTV. For these cases, the ovarian mean dose of IMRT and VMAT were (459.1±239.9) and (428.3±238.2) cGy, respectively (z=3.11,P=0.002). The ovarian mean dose has the highest correlation and negative correlation with the closest lateral distance from the ovarian volume center to the PTV surface (IMRT, r=-0.922,P=0.001;VMAT, r=-0.865,P=0.001). To reduce the ovarian mean dose to 500 cGy, the lateral closest distance between the ovarian volume center and the PTV surface should be 3.6 cm and 3.3 cm for IMRT and VMAT respectively. Conclusions There is no difference between the two planned ovarian doses when the ovaries were located above the upper boundary of the PTV. When the ovaries were located in the same level with PTV, the VMAT plan is better than IMRT in both ovarian dose and treatment efficiency. The ovarian dose could be predicted by the lateral closest distance from the ovarian volume center to the PTV. |
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