CAJ | 학술논문

目的探讨体外放疗联合CT影像为基础近距离放疗的宫颈癌患者DVH参数和治疗结果间关系.方法 2008-2011年间18例接受根治性放疗的ⅡB—ⅢB期宫颈癌患者进行了常规放疗加CT为基础的近距离三维放疗.观察两种放疗相加的高危CTV的D90和直肠、膀胱的D2cm3、D1cm3,采用EQD2进行剂量叠加.同时随访患者不良反应.结果 A点剂量为(93.0±5.5) Gy,高危CTV D90为(73.6±11.9) Gy.患者中位随访时间为26个月,无复发病例.8例患者出现轻中度直肠晚期反应,其直肠D2 cm3、D1cm3均高于无反应者[(87.4±3.8) Gy:(75.8±7.4) Gy,P=0.004;(96.4±6.6) Gy:(80.5±7.1) Gy,P=0.001].结论 CT引导的宫颈癌三维近距离放疗高危CTVD90剂量比文献报道略低,直肠D2 cm3建议＜75 Gy.
목적 탐토체외방료연합CT영상위기출근거리방료적궁경암환자DVH삼수화치료결과간관계.방법 2008-2011년간18례접수근치성방료적ⅡB—ⅢB기궁경암환자진행료상규방료가CT위기출적근거리삼유방료.관찰량충방료상가적고위CTV적D90화직장、방광적D2cm3、D1cm3,채용EQD2진행제량첩가.동시수방환자불량반응.결과 A점제량위(93.0±5.5) Gy,고위CTV D90위(73.6±11.9) Gy.환자중위수방시간위26개월,무복발병례.8례환자출현경중도직장만기반응,기직장D2 cm3、D1cm3균고우무반응자[(87.4±3.8) Gy:(75.8±7.4) Gy,P=0.004;(96.4±6.6) Gy:(80.5±7.1) Gy,P=0.001].결론 CT인도적궁경암삼유근거리방료고위CTVD90제량비문헌보도략저,직장D2 cm3건의＜75 Gy.
Objective To investigate the relationship between dose-volume histogram (DVH) parameters and the late side effects (LSE) of the rectum in external-beam radiotherapy combined with computed tomography (CT)-based brachytherapy for locally advanced cervical cancer.Methods From 2008 to 2011,18 patients with stage ⅡB-ⅢB cervical cancer received external-beam radiotherapy and CTbased brachytherapy.The DVH parameters of high-risk clinical target volume (HR CTV) D90,point A dose,and D1 cm3 and D2 cm3 of the rectum and bladder were calculated by Oncentra HDR treatment planning system.Survival outcomes were followed up and rectal LSE were evaluated by RTOG/EORTC grades.Results The point A dose and HR CTV D90 were (93.0 ± 5.5) Gy and (73.6 ± 11.9) Gy,respectively.The median follow-up was 26 months.No recurrence was found during follow-up.Eight patients had mild and moderate rectal LSE,and their rectum D2 cm3 and D1 cm3 were significantly higher than those of patients without mild and moderate rectal LSE (D2 cm3:(87.4 ± 3.8) Gy vs.(75.8 ± 7.4) Gy,P =0.004 ; D1 cm3:(96.4±6.6) Gy vs.(80.5± 7.1) Gy,P=0.001).Conclusions HR CTV D90 in CT-based brachytherapy for locally advanced cervical cancer might be lower than that in the MRI-based plan.Rectum D2 cm3 is recommended to be less than 75 Gy.