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插植针植入棒在妇科肿瘤术后残端近距离腔内放疗的应用
凌宝珍, 麦苗青, 曹新平, 叶伟军, 欧阳翼, 郭旋
中山大学肿瘤防治中心放疗科 华南肿瘤学国家重点实验室 肿瘤医学协同创新中心,广州 510060
Clinical application of new self-designed implanting applicator in vaginal three-dimensional intracavitary brachytheraypy after hysterectomy for gynecological cancer
Ling Baozhen, Mai Miaoqing, Cao Xinping, Ye Weijun, Ouyang Yi, Guo Xuan
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
Abstract：Objective Investigate the safety and feasibility of using the new self-designed implanting applicator in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, and to explore the clinical value of the self-designed implanting applicator. Methods Sixty-two gynecological cancer patients who underwent brachytherapy in Sun Yat-sen University Cancer Center were selected in this study. Each patient received three-dimensional intracavitary brachytherapy because of the indication of postoperative radiotherapy. Each patient was treated with different types of self-designed implanting applicators according the condition of postoperative vagina,and the vaginal tube and implant needle were placed in the template according to the preset channnel. Based on the actual CT images, the high-risk clinical target volume (HR-CTV), and organs at risk were defined according to unified target area delineation criteria and then the brachytherapy plan was conducted. The prescription dose of high-risk clinical target volume (HR-CTV) was 5.5 Gy/time. The parameters such as target area, organs at risk volume and irradiated dose were evaluated by DVH diagram. Results Sixty-two patients successfully completed brachytherapy under the guidance of self-designed implanting applicator. A total of 140 implantation treatments were performed. The total average dose of HR-CTV D90% was (575.48±22.30) cGy, the mean dose D2cm³ of bladder, rectum and sigmoid colon were (328.69±102.71), (369.14±46.59) and (27.28±71.27) cGy, the small intestine did not drop the target area, so there was no statistics. There was statistical significance between target volume and organs at risk dose (P<0.05). Conclusions The new self-designed implanting applicator has obvious clinical advantages in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, meets the requirements of the preset planning dose,and it is sample to operate and highly safe,which indicated a bright future of the clinical application.
Ling Baozhen,Mai Miaoqing,Cao Xinping et al. Clinical application of new self-designed implanting applicator in vaginal three-dimensional intracavitary brachytheraypy after hysterectomy for gynecological cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(7): 622-627.
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