[1]鲍志荣,王大奖,陈诚,等. 不同骨盆勾画及限量方式下宫颈癌术后IMRT计划的剂量学研究[J].中国医学物理学杂志,2019,36(9):1023-1028.[doi:DOI:10.3969/j.issn.1005-202X.2019.09.006]
　BAO Zhirong,WANG Dajiang,CHEN Cheng,et al. Dosimetric study of intensity-modulated radiotherapy with different pelvic delineations and dose limitations following surgery for cervical cancer[J].Chinese Journal of Medical Physics,2019,36(9):1023-1028.[doi:DOI:10.3969/j.issn.1005-202X.2019.09.006]
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 不同骨盆勾画及限量方式下宫颈癌术后IMRT计划的剂量学研究()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第9期
页码:
1023-1028
栏目:
医学放射物理
出版日期:
2019-09-25

文章信息/Info

Title:
 Dosimetric study of intensity-modulated radiotherapy with different pelvic delineations and dose limitations following surgery for cervical cancer
文章编号:
1005-202X（2019）09-1023-06
作者:
 鲍志荣1; 2; 3; 王大奖1; 2; 3; 陈诚1; 2; 3; 陈敏1; 2; 3; 刘晖1; 2; 3; 戴静1; 2; 3; 谢丛华1; 2; 3
 1.武汉大学中南医院放化疗科， 湖北 武汉 430071； 2.湖北省肿瘤生物学行为重点实验室， 湖北 武汉 430071； 3.湖北省肿瘤医学临床研究中心， 湖北 武汉 430071
Author(s):
 BAO Zhirong1; 2; 3;  WANG Dajiang1; 2; 3;  CHEN Cheng1; 2; 3;  CHEN Min1; 2; 3;  LIU Hui1; 2; 3;  DAI Jing1; 2; 3;  XIE Conghua1; 2; 3
 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
关键词:
 ; 宫颈癌; 调强放射治疗; 保护骨盆; 剂量学
Keywords:
 ; Keywords: cervical cancer;  intensity-modulated radiotherapy;  pelvis sparing;  dosimetry
分类号:
R737.33；R815
DOI:
DOI:10.3969/j.issn.1005-202X.2019.09.006
文献标志码:
A
摘要:
 目的：研究宫颈癌术后放疗患者不同骨盆勾画及限量方式对调强放射治疗（IMRT）计划剂量的影响。方法：选取11例宫颈癌术后患者，对患者CT图像勾画靶区和小肠、直肠、膀胱、股骨头、髋骨、腰骶骨、骨盆等危及器官。针对每例患者分别设计3个计划，包括限制骨盆的IMRT（BM）计划、限制髋骨的IMRT（OC）计划以及限制髋骨和腰骶骨的IMRT（OC+LS）计划，并评估3组计划的靶区和危及器官的剂量分布。结果：3组计划的计划靶区覆盖率均能满足临床要求，且小肠、直肠、膀胱、股骨头等危及器官的剂量学参数相当，差异无统计学意义（P>0.05）。对于骨盆剂量，对髋骨和腰骶骨进行限量的IMRT（OC+LS）计划的骨盆Dmean、V10、V20、V30、V40和腰骶骨Dmean、V20、V30、V40均显著低于其他两个计划（P<0.05）。与IMRT（BM）计划相比，IMRT（OC+LS）计划可使骨盆V20和V30降低约10.1%和8.0%。与IMRT（OC）计划相比，IMRT（OC+LS）计划可使腰骶骨的V20和V30降低约17.6%和27.9%。IMRT（OC）计划髋骨的剂量略低于IMRT（OC+LS）计划，但二者剂量体积参数差异均在1%以内。结论：宫颈癌术后放疗行保护骨盆的IMRT计划时，若将髋骨和腰骶骨限量，则可以在在满足靶区临床要求以及常规危及器官保护的基础上，有效降低骨盆受量，更好地保护骨髓。
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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备注/Memo

备注/Memo:
 【收稿日期】2019-03-20
【作者简介】鲍志荣，硕士，物理师，研究方向：放射物理，E-mail: bao_zhirong@163.com
【通信作者】谢丛华，博士，主任医师，研究方向：恶性肿瘤及精确放疗，E-mail: chxie_65@whu.edu.cn
更新日期/Last Update: 2019-09-23