[1]成坚强,安永伟,陶娜,等.3种宫颈癌近距离放射治疗技术剂量学研究[J].中国医学物理学杂志,2022,39(10):1199-1203.[doi:DOI:10.3969/j.issn.1005-202X.2022.10.003]
　CHENG Jianqiang,AN Yongwei,TAO Na,et al.Dosimetric comparison among 3 kinds of brachytherapy techniques in cervical cancer[J].Chinese Journal of Medical Physics,2022,39(10):1199-1203.[doi:DOI:10.3969/j.issn.1005-202X.2022.10.003]
点击复制

3种宫颈癌近距离放射治疗技术剂量学研究()
分享到：

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

卷:
39卷
期数:
2022年第10期
页码:
1199-1203
栏目:
医学放射物理
出版日期:
2022-11-02

文章信息/Info

Title:
Dosimetric comparison among 3 kinds of brachytherapy techniques in cervical cancer
文章编号:
1005-202X（2022）10-1199-05
作者:
成坚强; 安永伟; 陶娜; 牛瑞军; 魏玺仪; 张春林; 高力英; 魏世鸿
甘肃省肿瘤医院放疗科， 甘肃 兰州 730050
Author(s):
CHENG Jianqiang;  AN Yongwei;  TAO Na;  NIU Ruijun;  WEI Xiyi;  ZHANG Chunlin;  GAO Liying;  WEI Shihong
Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
关键词:
宫颈癌; 近距离治疗; 3D打印; 插植治疗
Keywords:
Keywords: cervical cancer brachytherapy 3D printing interstitial treatment
分类号:
R737.33；R816.91
DOI:
DOI:10.3969/j.issn.1005-202X.2022.10.003
文献标志码:
A
摘要:
目的：基于三维后装不同模式近距离治疗方案，分析研究不同技术后装治疗过程中靶区和危及器官（OARs）的物理剂量差异。方法：选取72例宫颈癌患者进行回顾性分析，根据施源器的不同模式分为以下3类：常规三维腔内治疗（ICBT）组、徒手插植（ISBT）组和3D打印阴道塞（3DP-ISBT）组。分析不同组别的OARs受量情况。结果：ISBT组平均4根插植针，3DP-ISBT组平均6根插植针，3D打印阴道塞针数多于徒手插植针数量，差异有统计学意义（P<0.001）。3组两两比较，HR-CTV靶区剂量D90和HR-CTV靶区体积差异均没有统计学意义（P>0.05）。以ICBT组作为对照，膀胱受量（D0.1 cc、D1 cc和D2 cc）ISBT组和3DP-ISBT组均显著低于ICBT组（P<0.01），但是ISBT组和3DP-ISBT组之间差异没有统计学意义（P=0.993）。直肠D0.1 cc、D1 cc和D2 cc 3组之间差异没有统计学意义。以ICBT组作为对照，小肠受量（D0.1 cc、D1 cc和D2 cc）ISBT组和3DP-ISBT组显著低于ICBT组（P<0.01）。ISBT组和3DP-ISBT组比较，小肠D0.1 cc、D1 cc和D2 cc 3DP-ISBT组显著低于ISBT组（P<0.01）。结论：通过分析3种近距离治疗模式的OARs受照剂量情况，ISBT技术相比ICBT技术在保护膀胱和小肠方面有较大的优势，其中3DP-ISBT在膀胱和小肠的保护方面是最优的，在直肠保护方面没有显示出明显优势。
Abstract:
Abstract: Objective To analyze the differences in doses to target areas and organs-at-risk during brachytherapy in different modes. Methods According to the different modes of the applicator, 72 patients with cervical cancer were divided into 3 groups, namely conventional three-dimensional intracavitary brachytherapy (ICBT) group, interstitial brachytherapy (ISBT) group and 3D printing interstitial brachytherapy (3DP-ISBT) group. The doses to organs-at-risk in different groups were analyzed. Results The average number of interstitial needles in 3DP-ISBT group was more than that of ISBT group (6 vs 4, P<0.001). The comparison between any 2 groups showed that there was no significant difference in D90 and target volume of HR-CTV (P>0.05). The D0.1 cc, D1 cc and D2 cc of the bladder in ISBT group and 3DP-ISBT group were significantly lower than those in ICBT group (P<0.01), but the differences between ISBT group and 3DP-ISBT group were trivial (P=0.993). No significant difference was found in the D0.1 cc, D1 cc and D2 cc of the rectum among 3 groups. The D0.1 cc, D1 cc and D2 cc of the small intestine in ISBT group and 3DP-ISBT group were significantly lower than those of ICBT group (P<0.01), and the D0.1 cc, D1 cc and D2 cc of the small intestine in 3DP-ISBT group were significantly lower than those of ISBT group (P<0.01). Conclusion By analyzing the exposure doses to organs-at-risk in 3 brachytherapy modes, ISBT is advantageous over ICBT in sparing of bladder and small intestine. Among them, 3DP-ISBT has the optimal performance in the protection of the bladder and small intestine, but it shows no advantages in rectal sparing.

相似文献/References:

[1]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]
[2]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]
[3]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]
[4]刘 浩,王 新,李公平,等.用二维电离室矩阵验证宫颈癌腔内放疗剂量分布[J].中国医学物理学杂志,2014,31(04):4988.[doi:10.3969/j.issn.1005-202X.2014.04.004]
[5]余 辉,张书旭.宫颈癌后装治疗剂量的调强优化方法[J].中国医学物理学杂志,2014,31(05):5114.[doi:10.3969/j.issn.1005-202X.2014.05.004]
[6]查元梓,张松方,屠永清,等.子野权重优化对CMS XiO宫颈癌调强计划的影响[J].中国医学物理学杂志,2013,30(01):3866.[doi:10.3969/j.issn.1005-202X.2013.01.007]
[7]张富利,刘清智,张伟超,等.宫颈癌术后盆腔螺旋断层调强放疗两种计划设计方法的剂量学分析[J].中国医学物理学杂志,2013,30(04):4229.[doi:10.3969/j.issn.1005-202X.2013.04.003]
[8]王佳浩,赖建军,唐荣军,等.结合EPID与EUD方法确定宫颈癌病例靶区最佳生物外放边界的研究[J].中国医学物理学杂志,2013,30(05):4378.[doi:10.3969/j.issn.1005-202X.2013.05.009]
[9]张富利,刘清智,王雅棣,等.基于配置不同类型MLC叶片加速器的宫颈癌术后调强放疗计划评估[J].中国医学物理学杂志,2013,30(05):4383.[doi:10.3969/j.issn.1005-202X.2013.05.010]
[10]刘致滨,王占宇,龙雨松.两种优化技术在宫颈癌术后IMRT计划中的比较[J].中国医学物理学杂志,2015,32(04):534.[doi:10.3969/j.issn.1005-202X.2015.04.018]
　[J].Chinese Journal of Medical Physics,2015,32(10):534.[doi:10.3969/j.issn.1005-202X.2015.04.018]
[11]尹朝晟,吴嘉明,任益民.手算方式计算192Ir应用于宫颈癌近距离治疗的放置时间[J].中国医学物理学杂志,2017,34(2):139.[doi:10.3969/j.issn.1005-202X.2017.02.006]
　192Ir source dwelling time in brachytherapy for cervical cancer determined by hand calculation[J].Chinese Journal of Medical Physics,2017,34(10):139.[doi:10.3969/j.issn.1005-202X.2017.02.006]
[12]纪天龙,赵晶,李权,等. 驻留时间离差限制参数对三维后装计划的影响分析[J].中国医学物理学杂志,2018,35(8):900.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.007]
　JI Tianlong,ZHAO Jing,LI Quan,et al. Effects of dwell time deviation constraint parameters on three-dimensional afterloading plan[J].Chinese Journal of Medical Physics,2018,35(10):900.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.007]
[13]张丹凤,蒋俊,吴昊天,等.基于nnU-Net的宫颈癌近距离治疗中高危临床靶区及危及器官的自动勾画[J].中国医学物理学杂志,2023,40(12):1463.[doi:DOI:10.3969/j.issn.1005-202X.2023.12.003]
　ZHANG Danfeng,JIANG Jun,WU Haotian,et al.Auto-segmentation of high-risk clinical target volume and organs-at-risk for brachytherapy of cervical cancer based on nnUNet[J].Chinese Journal of Medical Physics,2023,40(10):1463.[doi:DOI:10.3969/j.issn.1005-202X.2023.12.003]

备注/Memo

备注/Memo:
【收稿日期】2022-04-15 【基金项目】中华国际医学交流基金会肿瘤精准放疗星火计划（2019-N-11-17）；甘肃省科技厅重点研发项目（20YF3FA017） 【作者简介】成坚强，硕士，工程师，物理师，主要从事肿瘤放射物理工作，E-mail: chengjianqzlyy@163.com 【通信作者】魏世鸿，硕士，主任医师，主要从事胸部肿瘤放化综合治疗工作，E-mail: weishihong100@163.com
更新日期/Last Update: 2022-10-27