宫颈癌根治术后盆腔淋巴囊肿对放疗的影响

The Affects of Cervical Cancer after Radical Hysterectomy with Pelvic Lymphocyst on Radiotherapy

目的:通过比较宫颈癌根治术后有无淋巴囊肿对术后放疗靶区CTV勾画以及周围危及器官剂量分布的影响,同时分析放疗后盆腔淋巴囊肿的转归情况,探讨宫颈癌术后并发盆腔淋巴囊肿患者的治疗方式。方法:38例宫颈癌根治术后患者,其中26例无盆腔淋巴囊肿,12例并发盆腔淋巴囊肿。给予同样的3DCRT方式放疗,靶区CTV包阴道4cm、宫旁组织、闭孔、骶前、髂内外以及髂总淋巴结,淋巴囊肿包括在靶区CTV内。予4野照射,前后野予6MV光子线,水平野予15MV光子线。通过剂量体积直方图(DVH)及放疗期间消化道急性期反应分析淋巴囊肿对放疗的影响,分析放疗对盆腔淋巴囊肿转归的影响。结果:在3DCRT放疗方式中有盆腔淋巴囊肿的患者靶区CTV显著比无淋巴囊肿的大。膀胱、小肠、直肠受照剂量和体积无差异,急性期肠道反应无明显增加。淋巴囊肿放疗后有效率91.7%。结论:宫颈癌术后并发盆腔淋巴囊肿及时予3DCRT放疗不增加放疗副反应并且疗效肯定,应及时进行术后放疗。

Objective ：By comparing whether the body has lymphocysts after the radical hysterectomy of cervical cancer.The influence of lymphocyst to volame CTV and dose distribution of the organs.Then we analyze the situations of lymphatic metastasis after the radiotherapy.Next, we discuss the treatment for the patient who has pelvic lymphocysts after the radical hysterectomy of cervical cancer.Methods ：To record 38 patients who were after the radical hysterectomy of cervical cancer.ln the 38 patients, 26 patients were without pelvic lymphocyst, 12 patients were with pelvic lymphocyst.Give them the same 3DCRT radiotherapy. The CTV covered vagina 4 era, uterine tissue, obturator, presacral , iliac external iliac and common ihac lymphatic, lymphocyst was included in the target volume CTV.Given four radiation fields, Design of the anterior, posterior vertical field with 6 MV X-ray and double horizontal lateral fields with 15 MV X-ray. According to DVH and the reactions of Digestive tract acute phrase during the radiotherapy during the radiotherapy, to analyze the influence of lymphocyst to the radiotherapy and the influence of radiotherapy to pelvic lymphocy metastasis.Results ：In 3DCRT, the CTV of the man who had pelvic lymphocysts was much bigger than the man who had no pelvic lymphocysts.There was no differences between the exposure dose and the volume.The acute intestinal reaction was not increased obviously.The efficiency of the lymphocys after radiotherapy was 91.7%.Conclusion ：The pelvic lymphocyst after the hysterectomy of cervical cancer should give 3DCRT in time, the side reaction of radiotherapy is not increased and the curative effect is worth to be sure.