局部晚期宫颈癌三维适形近距离治疗中ICRU参考点剂量与OAR体积剂量参数的关系研究

doi:10.3760/cma.j.issn.1004-4221.2016.05.014

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摘要目的比较局部晚期宫颈癌三维适形近距离治疗中膀胱、直肠不同充盈状态下OAR的ICRU参考点剂量与体积剂量参数之间关系。方法 MRI引导宫颈癌三维适形近距离治疗患者31例,共96分次,在TPS中确定ICRU直肠、膀胱参考点,记录其剂量,分别与直肠、膀胱体积剂量参数进行比较,配对t检验其差异。结果膀胱D_ICRU小于膀胱D_{0.1 cm³}和D_{1 cm³}(P=0.000、0.000),大于D_{5 cm³}和D_{10 cm³}(P=0.000、0.000),与D_{2 cm³}相近(P=0.345)。膀胱充盈状态下,膀胱的D_ICRU小于膀胱D_{2 cm³}。直肠D_ICRU小于直肠D_{0.1 cm³}和D_{1 cm³}(P=0.000、0.002),大于D_{5 cm³}和D_{10 cm³}(P=0.000、0.000),与D_{2 cm³}相近(P=0.058)。膀胱、直肠ICRU参考点剂量与各自的D_{2 cm³}呈正相关。膀胱体积≥200 cm³,ICRU膀胱参考点会低估膀胱的D_{2 cm³}剂量。直肠体积≥37 cm³,ICRU直肠参考点会低估直肠的D_{2 cm³}剂量;直肠体积<37 cm³,ICRU直肠参考点会高估直肠的D_{2 cm³}剂量。结论在三维适形近距离治疗中采用D_{2 cm³}作为评价OAR指标是基本安全的,但当膀胱、直肠处于排空状态时还需分别参考膀胱、直肠ICRU点剂量。

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	赵红福
	韩东梅
	程光惠
	施丹
	朱永刚
	赵志鹏
	葛禹辛

关键词 ：宫颈肿瘤/近距离放射疗法, 近距离放射疗法, 三维适形, 剂量学

Abstract： Objective To investigate the correlation between ICRU reference point dose and dose-volume parameters of organs at risk (OARs) under different bladder and rectal filling status in three-dimensional conformal brachytherapy for locally advanced cervical cancer. Methods A total of 31 patients who received magnetic resonance imaging-guided three-dimensional conformal brachytherapy for cervical cancer in 96 fractions were enrolled. The ICRU rectal and bladder reference points were determined in the treatment planning system, and the doses at these points were recorded and compared with the dose-volume parameters of the rectum and bladder. The paired t-test was used to analyze the differences between them. Results Bladder D_ICRU was lower than bladder D_{0.1 cm³} and D_{1 cm³}(P=0.000 and 0.000), higher than bladder D_{5 cm³} and D_{10 cm³}(P=0.000 and 0.000), and similar to bladder D_{2 cm³}(P=0.345). Under the bladder filling status, bladder D_ICRU was lower than D_{2 cm³}. Rectal D_ICRU was lower than rectal D_{0.1 cm³} and D_{1 cm³}(P=0.000 and 0.002), higher than rectal D_{5 cm³} and D_{10 cm³}(P=0.000 and 0.000), and similar to rectal D_{2 cm³}(P=0.058). The ICRU bladder and rectal reference point doses were positively correlated with corresponding D_{2 cm³}. In the case of bladder volume ≥200 cm³, the ICRU bladder reference point dose underestimated bladder D_{2 cm³}. In the case of rectal volume ≥37 cm³, the ICRU rectal reference point dose overestimated rectal D_{2 cm³}. Conclusions In three-dimensional conformal brachytherapy, it is generally safe to use D_{2 cm³} as an index to evaluate OARs, but when the bladder or rectum is in an empty status, the ICRU bladder or rectal reference point doses should be considered.

Key words： Cervical neoplasms/bractherapy Bractherapy,three-dimensional conformal Dosimetry

收稿日期: 2015-12-08

基金资助:吉林省科技厅项目(20090458);吉林省卫生计生委项目(2014ZC054);吉林省科技厅白求恩专项(20160101079JC);吉林大学横向课题(2015373)

通讯作者: 程光惠,Email:chengguanghuifl@163.com

引用本文:

赵红福,韩东梅,程光惠等. 局部晚期宫颈癌三维适形近距离治疗中ICRU参考点剂量与OAR体积剂量参数的关系研究[J]. 中华放射肿瘤学杂志, 2016, 25(5): 483-487.

Zhao Hongfu,Han Dongmei,Cheng Guanghui et al. Correlation between ICRU reference point dose and dose-volume parameters of organs at risk in three-dimensional conformal brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 483-487.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2016.05.014 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2016/V25/I5/483

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