妇科肿瘤后装逆向调强放疗的初步临床研究

Preliminary clinical research on the afterloading brachytherapy inverse intensity-modulatedradiotherapy of gynecological tumor

目的评价后装逆向调强放疗技术在妇科肿瘤治疗中的临床价值。方法选取20例I～Ⅲ期宫颈癌患者，采用随机数字表和余数分组的方法分为A、B两组，各10例。A组病例行后装逆向调强放疗，B组病例行三维适形后装放疗。分析两组患者的靶区剂量分布、危及器官受量、放疗并发症及近期疗效。结果A组靶区剂量均匀度指数（H1）为52．43±0．45，好于B组的46．37±1．45（t=0．92，P〈0．05）；A组直肠、膀胱最大受量Dmax分别比B组低37％、35％（t=1．34、1．39，P〈0．05），A组75％处方剂量的直肠、膀胱受照体积k约为B组的1／2（t=1．23、1．13，P〈0．05）；A组局部控制率96％好于B组的93％（t=1．25，P〈0．05）。结论后装逆向调强放疗优于三维适形后装放疗．值得在妇科肿瘤治疗中广泛府用。

Objective To evaluate the clinical value of the afterloading brachytherapy inverse intensity-modulated radiotherapy of gynecological tumor. Methods Twenty patients with cervical cancer, were randomly divided into A and B groups, 10 cases for each group. Group A received the afterloading brachytherapy inverse intensity-modulated radiotherapy. Group B received the three-dimensional comformal afterloading brachytherapy. The target volume dose distribution, organs at risk （rectum, bladder） , short- term curative effect and radioactive complications were analyzed on both groups. Results The dose homogeneity index of the target volume of group A was 52. 43 ± 0.45, better than that of group B（46.37 ± 1.45 ） （ t = 0. 92 ,P 〈 0. 05 ）. The maximum dose of rectum and bladder of group A were about 37% , 35% , less than that of group B （t = 1.34,1.39, P 〈 0.05）. The 75% prescription dose irradiated volume of rectum and bladder of group A were about only 1/2 of group B（ t = 1.23,1.13 ,P 〈 0.05 ）. The local control rate of 96% for group A was better than 93% for group B （ t = 1.25, P 〈 0.05 ）. Conclusions Afterloading brachytherapy inverse intensity-modulated radiotherapy technique could be better than the three-dimensional comformal afterloading brachytherapy. It should be recommended for gynecological tumor.