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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2016, Vol. 25 Issue (9): 950-954    DOI: 10.3760/cma.j.issn.1004-4221.2016.09.009
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乌德勒支施源器在宫颈癌3D-IGBT应用观察
赵志鹏,张宁,程光惠,何明远,施丹,赵红福
130000 长春,吉林大学中日联谊医院放疗科
The clinical application research of Utrecht applicator in three-dimensional image guided brachytherapy (3D-IGBT) for cervical cancer
Zhao Zhipeng,Zhang Ning,Cheng Guanghui,He Mingyuan,Shi Dan,Zhao Hongfu
Department of Radiation Oncology,China-Japan Union Hospital of Jilin University,Changchun 130000,China
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摘要 目的 观察乌德勒支施源器在局部晚期宫颈癌3D-IGBT中的临床应用情况,揭示其在IC-IS的应用规律。方法 回顾分析45例接受根治性放疗的局部晚期宫颈癌患者,外照射后行3D-IGBT,其中45例130次IC-IS入组。将满足计划目标剂量分次定义为A组(37例86人次),余为B组(22例44人次),成组t检验差异。结果 施源器使用15、20、25 mm卵圆体的频率分别为50.0%、20.0%、30.0%,30 mm型号无使用。共置插植针499根,6、7、10、11孔位使用频率分别为23.1%、21.2%、21.2%、24.1%。A组平均插植针数为3.7根明显少于B组4.2根(P=0.008)。A组的HR-CTV平均体积为(40.71±18.43) cm3小于B组(51.81±14.74) cm3(P=0.001),A组HR-CTV的宽和高小于B组(P=0.011、0.006);而厚相似(P=0.595)。高与插植深度的差两组相似(P=0.366),宽与左右针孔间距的差A组小于B组(P=0.007)。结论 局部晚期宫颈癌行IC-IS时,乌德勒支施源器的卵圆体多选用25 mm及以下型号,插植孔位多选用6、7、10、11号。在插植针数≥4根、深度≥3 cm时,宽度是影响计划剂量的主要因素。
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作者相关文章
赵志鹏
张宁
程光惠
何明远
施丹
赵红福
关键词 宫颈肿瘤/近距离疗法近距离疗法三维图像引导乌德勒支施源器腔内联合组织间插植计划目标剂量    
AbstractObjective To investigate the clinical application of Utrecht applicator in three-dimensional image-guided brachytherapy (3D-IGBT) for locally advanced cervical cancer,as well as its application discipline in intracavitary/interstitial (IC/IS) therapy. Methods A retrospective analysis was performed for the clinical data of 45 patients with locally advanced cervical cancer who received radical radiotherapy,and the patients received external beam radiotherapy followed by 3D-IGBT. A total of 130 times (n=45) of IC/IS therapy were performed,and the patients who received such therapy were all enrolled. The patients who met the target dose fractionation defined in the plan were enrolled as group A (n=37,86 times),and the other patients were enrolled as group B (n=22,44 times). Two groups difference was analyzed with Group t-test. Results The frequencies of use of 15-,20-,and 25-mm ovoids by the applicator were 50.0%,20.0%,and 30.0%,respectively,and the 30-mm ovoid was not used. A total of 499 needles were used,and the frequencies of use of 6,7,10,and 11 insertion holes were 23.1%,21.2%,21.2%,and 24.1%,respectively. Group A had a significantly lower mean number of the needles than group B (3.7 vs. 4.2,P=0.008). Compared with group B,group A had a significantly lower mean high-risk clinical target volume (CTV)(40.71±18.43 cm3 vs. 51.81±14.74 cm3,P=0.001),as well significantly lower width and height of high-risk CTV (P=0.011 and 0.006),but the thickness of high-risk CTV was similar between the two groups (P=0.595). The difference between height and insertion depth (DH) was similar between the two groups (P=0.366). Group A had a smaller difference between width and pinhole distance Dw than group B (P=0.007). Conclusions When IC/IS therapy is performed for locally advanced cervical cancer,the 15-,20-,and 25-mm ovoids of Utrecht applicator and 6,7,10,and 11 insertion holes are frequently used. When the number of needles is no less than 4 and the depth is no less than 3 cm,width is the major factor which affects the planned dose.
Key wordsCervical neoplasms/brachytherapy    Brachytherapy    three-dimentional image quided    Utrecht applicator    Interstitial /interstitial    Planning aim dose   
收稿日期: 2016-04-28     
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:   
赵志鹏,张宁,程光惠等. 乌德勒支施源器在宫颈癌3D-IGBT应用观察[J]. 中华放射肿瘤学杂志, 2016, 25(9): 950-954.
Zhao Zhipeng,Zhang Ning,Cheng Guanghui et al. The clinical application research of Utrecht applicator in three-dimensional image guided brachytherapy (3D-IGBT) for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(9): 950-954.
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