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 Dosimetric study of intensity-modulated radiotherapy with different pelvic delineations and dose limitations following surgery for cervical cancer(PDF)

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

Issue:
2019年第9期
Page:
1023-1028
Research Field:
医学放射物理
Publishing date:

Info

Title:
 Dosimetric study of intensity-modulated radiotherapy with different pelvic delineations and dose limitations following surgery for cervical cancer
Author(s):
 BAO Zhirong123 WANG Dajiang123 CHEN Cheng123 CHEN Min123 LIU Hui123 DAI Jing123 XIE Conghua123
 1. Department of Radiation and Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; 2. Hubei Province Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China; 3. Hubei Cancer Clinical Study Center, Wuhan 430071, China
Keywords:
 Keywords: cervical cancer intensity-modulated radiotherapy pelvis sparing dosimetry
PACS:
R737.33;R815
DOI:
DOI:10.3969/j.issn.1005-202X.2019.09.006
Abstract:
 Abstract: Objective To investigate the effect of pelvic delineation and dose limitation on the dosometric parameters of postoperative intensity-modulated radiotherapy (IMRT) in patients with cervical cancer. Methods Eleven patients receiving surgery for cervical cancer were enrolled in the study. Based on CT images, planning target areas (PTV) and organs-at-risks (OAR) such as small bowel, rectum, bladder, femoral head, os coxae (OC), lumbosacral spine (LS) and bone marrow (BM), were all delineated. A total of 3 plans, namely IMRT (BM) plan with BM sparing, IMRT (OC) plan with OC sparing and IMRT (OC+LS) plan with OC+LS sparing, were designed for each patient. The dose distributions in PTV and OAR in 3 plans were evaluated. Results All the PTV coverage in 3 plans satisfied the clinical requirements and no significant differences were found in the dosimetric parameters of small bowel, rectum, bladder and femoral head (P>0.05). Compared with the other two plans, IMRT (OC+LS) plan obviously reduced the Dmean, V10, V20, V30, V40 of BM and the Dmean, V20, V30, V40 of LS (P<0.05). The V20 and V30 of BM in IMRT (OC+LS) plan were decreased by 10.1% and 8.0% compared to IMRT (BM) plan while the V20 and V30 of LS was lowered by 17.6% and 27.9% compared to IMRT (OC) plan. Besides, the dosimetric parameters of OC in IMRT (OC) plan was slightly lower than that of IMRT (OC+LS) plan, but the differences were within 1%. Conclusion For patients with cervical cancer after surgery, IMRT plan with OC+LS sparing can significantly reduce the dose to pelvis and protect bone marrow better on the basis of satisfying the clinical requirements for target areas and conventional OAR sparing.

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Last Update: 2019-09-23