宫颈癌术后容积旋转调强放疗和常规静态调强放疗的照射剂量分布和血液毒性

A comparison of dose distribution and hematological toxicity of intensity modulated radiotherapy and volumetric-modulated arc therapy in patients after cervical cancer surgery

目的比较宫颈癌术后容积旋转调强放疗(VMAT)和常规静态调强放疗(IMRT)的照射剂量分布及其血液毒性。方法宫颈癌术后患者19例,10例行VMAT(A组),9例行IMRT(B组);比较两组盆腔骨髓(PBM)及其亚区接受5、10、20、30、40Gy后受照体积和血液毒性变化。结果采用30、40Gy照射,A组PBM及亚区的受照体积小于B组(P<0.05)。两组患者3级血液毒性发生率相仿(P>0.05),且均未发生4级血液毒性反应。结论两种放疗方法的血液毒性相仿;但与IMRT相比,VMAT可降低PBM及其亚区高剂量区的受照体积。

Objective To compare the dose distribution and hematological toxicity treated by volumetric-modulated arc therapy（VMAT） and intensity modulated radiotherapy（IMRT） in the patients after surgery for cervical cancer. Methods A total of 19 patients after cervical cancer surgery was randomized into two groups of A（treated with VMAT, 10 cases） and B（treated with IMRT, 9 cases）. The irradiated volume and hematological toxicity in pelvic bone marrow （PBM） and subregions were compared after receiving 5,10,20,30,40 Gy radiations between two groups. Results Treated with 30 and 40 Gy radiation, the irradiated volume was less in group A than that in group B （P〈0. 05）. The incidence of hematological toxicity at 3 grade was similar and there was no hematological toxicity at 4 grade in two groups （P〉0. 05 ）. Conclusion VMAT and IMRT have similar hematological toxicity. The former at high doses has less irradiated volume in PBM and subregions.