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术前术后宫颈癌膀胱充盈度一致性在调强放疗中对靶区及危及器官重要性研究
张蔚, 许青, 柯桂好, 朱俊, 贯士阔, 张艳俊
复旦大学上海医学院肿瘤学系/复旦大学附属肿瘤医院放疗中心 200032
Study on the significance of consistency of preoperative and postoperative bladder filling in patients with cervical cancer for target area and organ at risk in IMRT
Department of Radiation Oncology, Cancer Hospital of Fudan University;Department of Oncology, Shanghai Medical College of Fudan University, Shanghai 200032, China
Abstract：Objective Bladder filling in patients with cervical cancer before and after operation during intensity-modulated radiotherapy (IMRT) was controlled by using bladder volume measurement instrument (BVI 9400). The displacement errors of the target area and the changes of the irradiation dose and the morphology of the filling bladder were compared. The significance of consistency of preoperative and postoperative bladder filling in IMRT for cervical cancer was investigated.Methods Forty-five patients with cervical cancer treated with radiotherapy in our hospital in 2018 were recruited and divided into A,B and C groups (n=15). In group A, patients did not undergo surgery, patients in group B received radical resection of cervical cancer (bladder volume measurement (BVI 9400) was utilized to monitor the bladder urine volume in both A and B groups before treatment). In group C, patients who self-controlled urination without monitoring bladder urine volume before treatment were randomly selected. All patients in three groups underwent KV-CBCT scan before treatment for online registration analysis. The displacement errors in the x-(left and right),y-(head and foot),z-axis directions (ventral and dorsal), PTV coverage volume percentage(V100) and percentage difference (ΔV100) of the prescription dose were calculated.Results The average displacement errors in the x-, y-, z-axis directions were as follows:1.67 mm,1.55 mm and 1.67 mm in group A, 1.43 mm,1.58 mm and 1.84 mm in group B, and 2.27 mm,2.30 mm and 2.08 mm in group C, respectively. In group A, the V100 was calculated as 96.96% and ΔV100 was 1.17%. In group B, V100 was95.9% and ΔV100 was 1.29%. In group C, V100 was 94.02% and ΔV100 was 2.17%.Conclusions Controlling the consistency of bladder filling can reduce the effect of inconsistency of bladder filling upon the displacement errors to certain extent, which can guarantee the accuracy of the target location and the irradiation dose of the target, protect the bladder, small intestine and rectum, and alleviate the radiation-induced response of cervical cancer patients.
Zhang Wei,Xu Qing,Ke Guihao et al. Study on the significance of consistency of preoperative and postoperative bladder filling in patients with cervical cancer for target area and organ at risk in IMRT[J]. Chinese Journal of Radiation Oncology, 2019, 28(6): 438-441.
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2019, Vol. 28 
