宫颈癌三维后装治疗插植针路径优化的可行性研究

doi:10.3760/cma.j.issn.1004-4221.2020.03.013

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Abstract Objective To compare the dosimetric differences between free-hand method and virtually optimized method for implanting needles in intracavitary and interstitial combined brachytherapy (IC/IS BT) of cervical cancer, and to explore the improvement space of the existing interstitial brahcytherapy plan. Methods High-dose-rate cervical cancer IC/IS BT plans (short for Treatment-Plan) of 18 cases were retrospectively analyzed. For each treatment plan, Nucletron Oncentra 3D brachytherapy planning system was utilized to redesign the virtually optimized insertion method IC/IS BT plan (short for Optimized-Plan). Dose volume histogram was adopted to evaluate the dose distribution in high-risk clinical target areas and exposure dose to organ at risk (OAR). The plan execution efficiency between two plans was also assessed. Results Comparing these two plans, the differences in conformity and uniformity of dose distribution of the target area were statistically significant (P=0.000,0.008). The differences of D0.01 cm³, D1 cm³, D2 cm³ and D5 cm³ in bladder, rectum, sigmoid and small bowel were all statistically significant (all P<0.05). Optimized-Plan could reduce the D2 cm³ of bladder, rectum, sigmoid and small bowel by 60.41, 36.43, 27.53 and 12.43 cGy, respectively. The execution time for the Treatment-Plan and Optimized-Plan were (857.92±243.39) s and (804.53±239.13) s with statistical significance (P<0.001). Conclusions Compared with the free-hand method, virtually optimized method yields more conformable coverage of the target area and more uniform dose distribution. At the same time, the doses of each OAR are reduced to different degrees and the execution time of the plan is also shortened.

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	Chen Xiang
	Zhou Jianliang
	Zhang Xiang
	Wang Binbing

Key words： Cervical neoplasm/brachytherapy Interstitial implant Intracavitary irradiation

Received: 01 August 2018

Fund:Zhejiang Medical and Health Science and Technology Project (2015KYB053,2017PY013,2018PY005);Zhejiang Traditional Chinese Medicine Science and Technology Plan (2015ZB018);Open Project Support of Key Laboratory of Ministry of Radiation Physics and Technology Education (2018SCURPT09)

Corresponding Authors: Wang Binbing,Email:wangbb@zjcc.org.cn

Cite this article:

Chen Xiang,Zhou Jianliang,Zhang Xiang et al. Study of the feasibility of needle path optimization in 3D brachytherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(3): 215-219.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2020.03.013 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I3/215

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