CAJ | 학술논문

目的探讨CT引导下腔内联合组织间插植3D-IGBT局部晚期宫颈癌的剂量学优势.方法分析2013-2014年于本院接受根治性外照射及腔内联合组织间插植3D-IGBT的局部晚期宫颈癌患者45例,FIGO分期(2009年)为ⅠB2-ⅣA期.同一患者行腔内联合组织间插植192Ir治疗后,在原影像上去掉插植针作用,仅使用腔内施源器制定治疗计划.比较前后两组计划中高危CTV的D90％、中危CTV的D90％和膀胱、直肠、乙状结肠、小肠的D2cm3剂量学差异,并行配对t检验.结果共制定260次后装治疗计划,其中腔内联合组织间插植治疗计划130例、腔内治疗计划130例.腔内联合组织间插植治疗较腔内治疗高危CTV的D90％、中危CTV的D90％显著增高(P=0.000、0.000),膀胱、直肠的D2cm3显著降低(P =0.000、0.006).结论局部晚期宫颈癌使用腔内联合组织间插植3D-IGBT在获得更高靶区剂量的同时降低了膀胱、直肠受量.
목적 탐토CT인도하강내연합조직간삽식3D-IGBT국부만기궁경암적제량학우세.방법 분석2013-2014년우본원접수근치성외조사급강내연합조직간삽식3D-IGBT적국부만기궁경암환자45례,FIGO분기(2009년)위ⅠB2-ⅣA기.동일환자행강내연합조직간삽식192Ir치료후,재원영상상거도삽식침작용,부사용강내시원기제정치료계화.비교전후량조계화중고위CTV적D90％、중위CTV적D90％화방광、직장、을상결장、소장적D2cm3제량학차이,병행배대t검험.결과 공제정260차후장치료계화,기중강내연합조직간삽식치료계화130례、강내치료계화130례.강내연합조직간삽식치료교강내치료고위CTV적D90％、중위CTV적D90％현저증고(P=0.000、0.000),방광、직장적D2cm3현저강저(P =0.000、0.006).결론 국부만기궁경암사용강내연합조직간삽식3D-IGBT재획득경고파구제량적동시강저료방광、직장수량.
Objective To explore the dosimetric advantages of computed tomography-based and ultrasound-guided three-dimensional image-quided brachytherapy (3D-IGBT) combined with intracavitary/interstitial (IC/IS) brachytherapy for locally advanced cervical cancer.Methods A total of 45 patients with FIGO (2009) stage ⅠB2-ⅣA locally advanced cervical cancer who received radical external beam radiotherapy and 3D-IGBT combined with IC/IS brachytherapy in our hospital from 2013 to 2014 were analyzed.After the treatment with 192Ir-based IC/IS brachytherapy,patients had needles removed from the original images and received treatment only from IC radiation sources.Dosimetric differences in the planning D90 for high-risk clinical target volume (HR-CTV),D90 for intermediate-risk CTV (IR-CTV),and D2 cm3 for the bladder,rectum,sigmoid colon,and small intestines were determined and analyzed by paired t-test.Results A total of 260 after-loading treatment plans,including IC/IS treatment plans for 130 patients and IC treatment plans for 130 patients,were made.The D90 for HR-CTV and D90 for IR-CTV in the IC/IS brachytherapy group were significantly higher than those in the IC brachytherapy group (P =0.000;P =0.000).Moreover,the average D2cm3 values for the bladder and rectum were significantly reduced in the IC/IS brachytherapy group compared with those in the IC brachytherapy group (P =0.000;P =0.006).Conclusions The 3D-IGBT combined with IC/IS brachytherapy not only achieves a higher dose for the target volume,but also reduces the radiation dose to the bladder and rectum in the treatment of locally advanced cervical cancer.