CAJ | 학술논문

目的：探讨宫颈癌患者放疗过程中靶区体积、位置的改变。方法选择20例行宫颈癌放疗的患者，比较放疗前与放疗中期GTV、膀胱和直肠体积，以及三者边界在左、右、腹、背、头和脚6个方向上的位置变化。结果与放疗前相比，放疗中期20例患者GTV体积均缩小，差异有统计学意义（ P＜0.05）；膀胱和直肠体积变化差异无统计学意义（P＞0.05）；放疗中与放疗前GTV、膀胱、直肠的体积比≥70％，三者的空间重复体积比≤50％。GTV在左、右、头侧位移最大，膀胱在头、脚、腹侧位移最大，直肠在头、脚、背侧位移最大；放疗前与放疗中三者在6个方向上的位移差异有统计学意义（ P＜0.05）。结论宫颈癌患者放疗过程中膀胱、直肠体积均有变化，但无规律可言，加之靶区及正常组织的移动，放疗中期重新计划或自适应放疗是必要的。
목적：탐토궁경암환자방료과정중파구체적、위치적개변。방법선택20례행궁경암방료적환자，비교방료전여방료중기GTV、방광화직장체적，이급삼자변계재좌、우、복、배、두화각6개방향상적위치변화。결과여방료전상비，방료중기20례환자GTV체적균축소，차이유통계학의의（ P＜0.05）；방광화직장체적변화차이무통계학의의（P＞0.05）；방료중여방료전GTV、방광、직장적체적비≥70％，삼자적공간중복체적비≤50％。GTV재좌、우、두측위이최대，방광재두、각、복측위이최대，직장재두、각、배측위이최대；방료전여방료중삼자재6개방향상적위이차이유통계학의의（ P＜0.05）。결론궁경암환자방료과정중방광、직장체적균유변화，단무규률가언，가지파구급정상조직적이동，방료중기중신계화혹자괄응방료시필요적。
Objective To investigate changes in target volume and position during radiotherapy for cervical canc-er.Methods 20 patients with cervical cancer scheduled for radiotherapy were enrolled.GTV, bladder and rectum vol-ume were compared before and in the mid-phase of radiotherapy, as well as the boundary alterations in the left, right, ventral, dorsal, cranial and caudal directions.Results GTV volumes of all the 20 patients were statistically significantly reduced compared with that before radiotherapy (P<0.05).While the differences in bladder and rectal volume were not statistically significant (P>0.05).GTV, bladder and rectum volumes in the mid-phase of radiotherapy were not less than 70%of that before radiotherapy, with repeat spatial volume ratio not more than 50%.Maximum displacement was in left, right and cranial directions for GTV, in cranial, caudal and ventral directions for bladder, and in cranial, caudal and dorsal directions for rectum.Displacements of the target and the two organs in all 6 directions were statistically significant (P<0.05).Conclusion For patients with cervical cancer, volumes of bladder and rectum change in a random pattern during radiotherapy regimen, along with target and normal tissue movement.As a result, a secondary plan during radio-therapy regimen or adaptive radiotherapy is necessary.