CAJ | 학술논문

目的比较宫颈癌患者三维适形近距离治疗中膀胱体积改变对正常组织受量影响.方法 2012-2013年本院行宫颈癌根治性外照射+三维适形近距离治疗患者56例.行三维适形近距离治疗中分别将膀胱排空和充盈50、100、150 ml,比较不同膀胱充盈状态下直肠、小肠、乙状结肠及膀胱D0.1cm3、D1.0cm3、D2.0cm3并行配对t检验.结果直肠D0.1cm3在膀胱充盈50、100 ml后较排空状态明显减少(P =0.000、0.000);小肠D0.1cm3和D1.0cm3及D2.cm3在膀胱充盈50、100、150 ml较排空状态明显减少(P=0.008、0.000、0.000和0.000、0.000、0.000及0.000、0.000、0.000);膀胱D0.1cm3和D1.0cm3及D2.0cm3充盈100、150 ml后较排空状态明显增加(P=0.000、0.000和0.000、0.000及0.000、0.000).结论膀胱充盈状态改变了膀胱、小肠受量,对直肠、乙状结肠剂量影响较小;膀胱体积增加有利于降低小肠受量.在不改变膀胱受量前提下膀胱充盈50 nd较充盈100、150 ml更利于降低小肠受量.
목적 비교궁경암환자삼유괄형근거리치료중방광체적개변대정상조직수량영향.방법 2012-2013년본원행궁경암근치성외조사+삼유괄형근거리치료환자56례.행삼유괄형근거리치료중분별장방광배공화충영50、100、150 ml,비교불동방광충영상태하직장、소장、을상결장급방광D0.1cm3、D1.0cm3、D2.0cm3병행배대t검험.결과 직장D0.1cm3재방광충영50、100 ml후교배공상태명현감소(P =0.000、0.000);소장D0.1cm3화D1.0cm3급D2.cm3재방광충영50、100、150 ml교배공상태명현감소(P=0.008、0.000、0.000화0.000、0.000、0.000급0.000、0.000、0.000);방광D0.1cm3화D1.0cm3급D2.0cm3충영100、150 ml후교배공상태명현증가(P=0.000、0.000화0.000、0.000급0.000、0.000).결론 방광충영상태개변료방광、소장수량,대직장、을상결장제량영향교소;방광체적증가유리우강저소장수량.재불개변방광수량전제하방광충영50 nd교충영100、150 ml경리우강저소장수량.
Objective To evaluate the effect of bladder volume change on the doses to normal tissues in cervical cancer patients undergoing external three-dimensional conformal radiotherapy (3DRT)plus 3D conformal brachytherapy (3DCBT).Methods The study included 56 patients with cervical cancer who were admitted to our hospital from 2012 to 2013 and received radical external 3DRT and 3DCBT.During 3DCBT,the doses to 0.1,1.0,and 2.0 cm3(D0.1 cm3,D1.0cm3,and D2.0cm3,respectively) for the rectum,small intestine,sigmoid colon,and bladder under different bladder filling status (empty,50,100,and 150 ml) were compared and analyzed by paired t-test.Results The rectum D0.1cm3 with bladder volumes of 50and 100 ml were significantly reduced compared with that with an empty bladder (P =0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the small intestine with bladder volumes of 50,100,and 150 ml were significantly reduced compared with those with an empty bladder (P =0.008,0.000,0.000 and 0.000,0.000,0.000 or 0.000,0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the bladder with bladder volumes of 100 and 150 ml were significantly increased compared with those with an empty bladder (P =0.000,0.000 and 0.000,0.000 or 0.000,0.000).Conclusions The doses to the bladder and small intestine are influenced by different bladder filling status,but the doses to the rectum and sigmoid colon show no significant variation.The increase in bladder volume is helpful in reducing the dose to the small intestine.Without any change in the bladder dose,the bladder volume of 50 ml is more beneficial to reduce the dose to the small intestine than those of 100 and 150 ml.