Study on the correlation between acute radionuclitidis and improved body mass index in intensity-modulated radiation therapy after cervical cancer surgery
Chen Enle1, Yang Wan2, Gu Jiale3, Zhang Ke3, Deng Qinghua3, Ma Shenglin3, Li Xiadong3,4
1Department of Radiation Technology,Wenzhou Central Hospital,Wenzhou 325000,China; 2Department of Radiation Radiology,Wenzhou Central Hospital,Wenzhou 325000,China; 3Department of Radiation Oncology,Hangzhou First People' Hospital,Hangzhou Cancer Hospital,Hangzhou 310000,China; 4Sir Run Run Shaw Hospital,Zhejiang University School of Medicine;Institute of Translational Medicine,Zhejiang University,Hangzhou Cancer Hospital, 310000,China;
Abstract： Objective To investigate the relationship between the body mass index (BMI)/ body mass index improved (BMIIMPd) and the dose of the small intestine as well as the acute radiation colitis in the intensity-modulated radiation therapy after cervical cancer surgery. Methods Thirty-nine cervical cancer patients underwent postoperative adjuvant radiotherapy. All patients received Philips large bore CT scan for enhanced CT scan,target delineation and organ at risk. All patients were treated with a single arc 10 MV VMAT plan. The correlation between the radiation dose of the small intestine and the acute radiation enteritis and BMI/BMIIMPd was analyzed. Results The BMI was calculated as (22.23±2.80) kg/m2,BMIIMPd was (21.49±3.95) kg/m2,the small intestine volume VSI was (1 155.71 ± 419.33 )cc3. The volume of the small intestine received more than 10 Gy(V10_SI) VMAT was (66.50±27.01)%,and the equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were (4098.87±184.93) cGy and (7.98±8.73)%. One way ANOVA demonstrated that under the VMAT technology,the BMIIMPd,V30,V40,EUD (α=50) and NTCP in the small intestine were the influencing factors of the occurrence of acute radiation enteritis. Conclusions If the improved BMIIMPd is utilized to distinguish the BMI,the high dose area of the small intestine will be larger and the incidence of acute radiation enteritis will be higher for patients with BMIIMPd between 10.1 and 16.9(normal and thin). Conventional BMI cannot be utilized as a basis for the prediction of the incidence of acute radiation enteritis in patients with cervical carcinoma.
Chen Enle,Yang Wan,Gu Jiale et al. Study on the correlation between acute radionuclitidis and improved body mass index in intensity-modulated radiation therapy after cervical cancer surgery[J]. Chinese Journal of Radiation Oncology, 2019, 28(1): 23-26.
[1] Kim JH,Choi JH,Ki EY,et alIncidence and risk factors of lower extremity lymphedema after radical surgery with or without adjuvant radiotherapy in patients with FIGO stage Ⅰ to stage Ⅱ A cervical cancer[J].Int J Gynecol Cancer,2012,22(4):686-691.DOI:10.1097/IGC.0b013e3182466950. [2] 杨国姿,潘振宇,夏文明,等.容积旋转调强与固定野动态调强在宫颈癌术后放疗的剂量学比较[J].中华放射医学与防护杂志,2014,34(1):37-40.DOI:10.3760 cma.i.issn.0254-5098.2014.01.010. Yang GZ,Pan ZY,Xia WM,et al Dosimetric comparison and clinical application of RapidArc and intensity-modulated radiotherapy for postoperative radiotherapy of cervical cancer[J].Chin J Radiol Med Prot,2014,34(1):37-40.DOI:10.3760.cma.i.issn.0254-5098.2014.01.010. [3] Kim JH,Choi JH,Ki EY,et alIncidence and risk factors of lower extremity lymphedema after radical surgery with or without adjuvant radiotherapy in patients with FIGO stage Ⅰ to stage ⅡA cervical cancer[J].Int J Gynecol Cancer,2012,22(4):686-691.DOI:10.1097/IGC.0b013e3182466950. [4] 张照辉,贾廷珍,沈彤,等.放射性直肠炎的诊断和治疗——附97例病例分析[J].中华放射医学与防护杂忐,2006,26(I):29-30.DOI:10.3760/cma,j.issn,0254.5098.2006.01 010. Zhang ZH,Jia TZ,Shen T,et alDiagnosis and treatment of radiation proctitis analysis of 97 cases[J].Chin J Radiol Med Prot,2006,26(1):29-30 D01:10.3760/cma.j.issn.0254-5098.2006.01.010. [5] 郑敏,何玲,许敬辉,等.宫颈癌急性放射性直肠炎的剂量体积时间关系分析[J].中华放射医学与防护杂志,2017,37(3):205-208.DOI:10.3760/cma.i.issn.0254.5098.2017.03.008. Zheng M,He L,Xu JH,et al. An analysis of dose-volume-time relationship for acute radiation proctitis in cervical cancer patients[J] Chin J Radiol Med Prot,2017,37(3):205-208.DOI:10.3760/cma.i.issn.0254.5098.2017.03.008 [6] 涂剑楠,佐合拉古丽·木塔力甫,张洁.宫颈癌术后IG-VMAT剂量学及不良反应研究[J] 中华放射肿瘤学杂志,2017,26(4):410-413.DOI:10.3760/cma.j.issn.1004-4221.2017.04.009 Tu JN,Zuohelaguli·M,Zhang J,et alComparison of dosimetry and toxicities between postoperative fixed-field intensity-modulated radiotherapy and image-guided radiation therapy/volumetric modulated arc therapy for cervical cancer[J].Chin J Radiat Oncol,2017,26(4):410-413.DOI:10.3760/cma.j.issn.1004-4221.2017.04.009. [8] Lira JD,Johnson B,Valicenti R,et alThe impact of maximum rectal distention and tandem angle On rectal dose delivered in 3 D planned gynecologic high dose。rate brachytherapy[J].Int J Gynecol Cancer,2013,23(6):1078-1083.DOI:10.1097/IGC.ObOl3e3182959030.
2019, Vol. 28 
