[1]许晨迪,姜晓勃,王亚娟,等.基于扇形束CT研究不同固定体位下宫颈癌术后放疗中膀胱体积改变对膀胱和小肠受照剂量的影响[J].中国医学物理学杂志,2023,40(5):529-535.[doi:DOI:10.3969/j.issn.1005-202X.2023.05.001]
　XU Chendi,JIANG Xiaobo,WANG Yajuan,et al.Effects of bladder volume variation on doses to bladder and small bowel in postoperative radiotherapy for cervical cancer in different patient positioning: an analysis based on FBCT[J].Chinese Journal of Medical Physics,2023,40(5):529-535.[doi:DOI:10.3969/j.issn.1005-202X.2023.05.001]
点击复制

基于扇形束CT研究不同固定体位下宫颈癌术后放疗中膀胱体积改变对膀胱和小肠受照剂量的影响()
分享到：

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

卷:
40卷
期数:
2023年第5期
页码:
529-535
栏目:
医学放射物理
出版日期:
2023-05-26

文章信息/Info

Title:
Effects of bladder volume variation on doses to bladder and small bowel in postoperative radiotherapy for cervical cancer in different patient positioning: an analysis based on FBCT
文章编号:
1005-202X（2023）05-0529-07
作者:
许晨迪1; 2; 姜晓勃2; 王亚娟2; 刘镖水2; 彭应林2; 林志悦2; 林承光 2; 吴德华1
1.南方医科大学南方医院放疗科， 广东 广州 510515； 2.中山大学肿瘤防治中心/华南恶性肿瘤防治全国重点实验室/肿瘤医学协同创新中心， 广东 广州 510060
Author(s):
XU Chendi1; 2;  JIANG Xiaobo2;  WANG Yajuan2;  LIU Biaoshui2;  PENG Yinglin2;  LIN Zhiyue2;  LIN Chengguang2;  WU Dehua1
1. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China 2. Sun Yat-sen University Cancer Center/State Key Laboratory of Oncology in South China/Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
关键词:
宫颈癌; 放射治疗; 膀胱充盈度; 危及器官; 放疗体位
Keywords:
Keywords: cervical cancer radiotherapy bladder filling organs-at-risk radiotherapy positioning
分类号:
R737.33；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2023.05.001
文献标志码:
A
摘要:
目的：利用扇形束CT（FBCT）探讨宫颈癌术后放疗患者在不同固定体位下，膀胱体积的改变对膀胱、小肠的剂量学影响。方法：选取在中山大学肿瘤防治中心接受术后放疗的宫颈癌患者共22例，其中俯卧位固定患者10例，仰卧位固定患者12例，每次治疗前使用联影直线加速器uRT-linac 506c进行kV级FBCT，在放疗计划系统中对平移校正后的FBCT图像完成智能勾画，并复制原计划参数进行剂量计算。分析患者放疗过程中的膀胱体积变化趋势以及膀胱体积改变对膀胱和小肠受照剂量的影响。结果：22例患者在放疗过程中分次间膀胱体积与原计划膀胱体积均有不同程度的变化，且随着治疗进程，涨尿能力总体呈减弱趋势。仰卧位固定患者膀胱V45改变与膀胱体积变化率呈低度负相关（r=-0.431），膀胱V40、V30改变与膀胱体积变化率呈中度负相关（r=-0.651、r=-0.780），小肠V45、V40改变与膀胱体积变化率呈中度负相关（r=-0.701、r=-0.794），小肠V30改变与膀胱体积变化率呈高度负相关（r=-0.871）。而俯卧位固定患者膀胱V30改变与膀胱体积变化率呈低度负相关（r=-0.306），小肠V45改变与膀胱体积变化率呈低度负相关（r=-0.336），小肠V40、V30改变与膀胱体积变化率呈中度负相关（r=-0.505、r=-0.589）。结论：宫颈癌术后放疗患者治疗过程中分次间的膀胱体积与计划时的膀胱体积较难保持一致。相比于俯卧位固定，仰卧位固定患者的膀胱体积变化对其膀胱及小肠受照剂量的影响更大。
Abstract:
Abstract: Objective To investigate the dosimetric effect of bladder volume variation on bladder and small bowel in postoperative radiotherapy for cervical cancer in different patient positioning using fan beam computed tomography (FBCT). Methods A total of 22 cervical cancer patients who received postoperative radiotherapy in Sun Yat-sen University Cancer Center were retrospectively analyzed, including 10 patients in prone position and 12 patients in supine position. Before the treatment, kV FBCT was performed with UIH uRT-linac 506c accelerator. FBCT images after translational correction were automatically contoured in the treatment planning system, and the original plan parameters were copied for dose calculation. The trend of bladder volume variations and its effects on doses to bladder and small bowel were analyzed. Results The bladder volume of 22 patients changed to varying degrees during treatment. The urination ability showed a decreasing trend with the treatment course. For patients in supine position, the rate of bladder volume variations had a low negative correlation with V45 change of bladder (r=-0.431), moderate negative correlations with V40 and V30 changes of bladder (r=-0.651, r=-0.780) and V45 and V40 changes of small bowel (r=-0.701, r=-0.794), and a high negative correlation with V30 change of small bowel (r=-0.871). For patients in prone position, the rate of bladder volume variation had low negative correlations with V30 change of bladder and V45 change of small bowel (r=-0.306, r=-0.336), and moderate negative correlations with V40 and V30 changes of small bowel (r=-0.505, r=-0.589). Conclusion It is difficult to maintain the consistency of inter-fraction bladder volume in postoperative radiotherapy for cervical cancer, and the doses to bladder and small bowel are more affected by bladder volume variation in supine position as compared with prone position.

相似文献/References:

[1]武 杰,袁杭英,欧阳蓓蕾.内旋式放射治疗用面罩固定装置的设计[J].中国医学物理学杂志,2015,32(02):265.[doi:10.3969/j.issn.1005-202X.2015.02.027]
[2]戴相昆,杨丰蔚,杜 镭,等.等效均匀剂量优化法在宫颈癌调强计划中的应用[J].中国医学物理学杂志,2015,32(02):290.[doi:10.3969/j.issn.1005-202X.2015.02.033]
[3]司 森,吴鑫全,包尚联,等.基于GPU的蒙特卡洛放疗剂量模拟[J].中国医学物理学杂志,2015,32(01):1.[doi:10.3969/j.issn.1005-202X.2015.01.001]
[4]王 文,程梦云,杨 琪,等.基于MCNP源子程序的放射治疗剂量计算验证方法[J].中国医学物理学杂志,2015,32(01):13.[doi:10.3969/j.issn.1005-202X.2015.01.004]
[5]张一戈,邱小平,陈维军,等.基于图像引导技术对头颈部肿瘤临床摆位误差的剂量学影响[J].中国医学物理学杂志,2015,32(01):25.[doi:10.3969/j.issn.1005-202X.2015.01.007]
[6]孟慧鹏,孙小喆,王 昊,等.胸部偏后背肿瘤RapidArc采用仰卧位设计治疗计划的可行性分析[J].中国医学物理学杂志,2015,32(01):31.[doi:10.3969/j.issn.1005-202X.2015.01.008]
[7]刘 浩,王 新,李公平,等.宫颈癌放疗高危临床靶区变化及其对累计吸收剂量的影响[J].中国医学物理学杂志,2015,32(03):379.[doi:10.3969/j.issn.1005-202X.2015.03.017]
[8]庞皓文,孙小扬.基于快速自由形变的弹性配准算法在放疗CT中的应用[J].中国医学物理学杂志,2015,32(03):404.[doi:10.3969/j.issn.1005-202X.2015.03.023]
[9]孙晓欢,周咏春,谭丽娜,等.容积旋转调强与固定野调强在宫颈癌术后放疗中的剂量学比较[J].中国医学物理学杂志,2014,31(01):4604.[doi:10.3969/j.issn.1005-202X.2014.01.003]
[10]贾卫娟,周一兵,谭维维,等.利用模拟机及挡铅托架进行放疗前的治疗模拟[J].中国医学物理学杂志,2014,31(01):4622.[doi:10.3969/j.issn.1005-202X.2014.01.007]
[11]刘娟,李双双,高山宝,等. 宫颈癌螺旋断层放疗与静态调强技术的剂量学比较[J].中国医学物理学杂志,2019,36(1):23.[doi:DOI:10.3969/j.issn.1005-202X.2019.01.005]
　LIU Juan,LI Shuangshuang,GAO Shanbao,et al. Dosimetric comparison of helical tomotherapy versus fixed-field intensity-modulated radiotherapy for cervical cancer[J].Chinese Journal of Medical Physics,2019,36(5):23.[doi:DOI:10.3969/j.issn.1005-202X.2019.01.005]
[12]王金媛,徐寿平,杨微,等.算法和匹配数目对宫颈癌危及器官自动勾画的影响[J].中国医学物理学杂志,2019,36(11):1243.[doi:DOI:10.3969/j.issn.1005-202X.2019.11.001]
　WANG Jinyuan,XU Shouping,YANG Wei,et al.Effects of algorithm and matching number on the auto-segmentation of organs-at-risk in patients with cervical cancer[J].Chinese Journal of Medical Physics,2019,36(5):1243.[doi:DOI:10.3969/j.issn.1005-202X.2019.11.001]
[13]黄洋洋,李家兵,田玉龙,等.宫颈癌直线加速器放疗时保卵巢对靶区和危及器官的影响[J].中国医学物理学杂志,2020,37(9):1115.[doi:10.3969/j.issn.1005-202X.2020.09.007]
　HUANG Yangyang,LI Jiabing,TIAN Yulong,et al.Effects of ovaries sparing on planning target volume and organs-at-risk during linearaccelerator radiotherapy for cervical cancer[J].Chinese Journal of Medical Physics,2020,37(5):1115.[doi:10.3969/j.issn.1005-202X.2020.09.007]
[14]梁黎,李勇.体质量指数对锥形束CT引导的宫颈癌放疗分次间摆位误差的影响[J].中国医学物理学杂志,2023,40(2):144.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.003]
　LIANG Li,LI Yong.Effect of body mass index on inter-fractional setup errors in cone beam CT-guided radiotherapy of cervical cancer[J].Chinese Journal of Medical Physics,2023,40(5):144.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.003]

备注/Memo

备注/Memo:
【收稿日期】2022-12-26 【基金项目】国家重点研发计划（2022YFC2402300）；国家自然科学基金（12005316）；广州市科技计划项目（202206010154, 202206010180） 【作者简介】许晨迪，硕士，技师，研究方向：放射治疗技术学，E-mail: huchd@sysucc.org.cn 【通信作者】吴德华，博士，教授，研究方向：肿瘤放射治疗学，E-mail: 18602062748@163.com
更新日期/Last Update: 2023-05-26