IMRT中手术与非手术宫颈癌患者危及器官受照剂量的研究

A study of exposure doses delivered to organ-at-risk of patients with cervical cancer who accepted surgical and non-surgical treatment in IMRT

目的比较调强放射治疗(IMRT)中手术与非手术宫颈癌患者危及器官的受照剂量。方法将10例宫颈癌患者根据是否接受手术治疗分为手术组(n=5)和非手术组(n=5),所有患者均采用CT模拟定位机扫描,IMRT计划靶区勾画标准相同,在GMS治疗计划系统上测定危及器官(如小肠,膀胱,左、右股骨头及直肠)的受照剂量,小肠、直肠:5%体积受照剂量(D5)、D10、D20、D30、D40、D50;膀胱:D10、D20、D30、D40、D50;左、右股骨头:D20、D30、D40、D50及其平均剂量、最大剂量、最小剂量。结果手术组患者小肠,膀胱,直肠及左、右股骨头不同体积的受照剂量与非手术组比较,差异无统计学意义(P>0.05)。结论宫颈癌手术后,只要靶区勾画正确,IMRT不会增加危及器官的受照剂量。

Objective To compare the exposure doses delivered to organ-at-risk of patients with cervical cancer who accepted surgical and non-surgical treatment in intensity-modulated radiation therapy（IMRT）.Methods 10 patients with cervical cancer were divided into surgical group（n=5） and non-surgical group（n=5）according to whether or not to receive surgical treatment.All patients were subjected to scanning using CT simulation machine with the same standard of planned target delineation in IMRT.Exposure doses delivered to organ-at-risk（such as small intestine,bladder,left and right femoral head,rectum） were detected in the GMS treatment planning system：dose to 5% of target volume（D5）,D10,D20,D30,D40,D50 of small intestine and rectum;D10,D20,D30,D40,D50 of Bladder;D20,D30,D40,D50 of left and right femoral head,and their average dose,maximum dose and minimum dose.Results Comparison the exposure doses delivered to different volume of small intestine,bladder,rectum,left and right femoral head of patients in surgical group with those in non-surgical group,differences showed no statistical significance（P0.05）.Conclusion IMRT does not increase the exposure dose delivered to organ-at-risk after surgical treatment for cervical cancer as long as the target is delineated correctly.