宫颈癌术后三维适形放疗与正向调强放疗的剂量学比较

Dosimetric Comparison of Three-dimensional Conformal Radiotherapy and Forward Intensity Modulated Radiotherapy for Cervical Carcinoma

目的:比较宫颈癌术后三维适形放疗(3DCRT)与正向调强放疗的剂量学差异。方法:选取2016年9月至2018年10月石河子大学医学院第一附属医院收治的进行过手术并行放射治疗的宫颈癌患者30例,分别制定3DCRT、正向调强放疗计划。通过DVH图进行自身对照研究,比较计划靶区(PTV)及危及器官(OAR)受量分布差异。结果:正向调强计划组PTV的Dmax、Dmean显著低于3DCRT组(P=0.001,P=0.002),Dmin、CI95%明显高于3DCRT组(P=0.016,P<0.001);正向调强计划组的小肠、直肠、膀胱、双侧股骨头等OAR的Dmean均低于3DCRT计划组(P=0.004),在高剂量区的受照体积V40、V45明显低于3DCRT计划组(P<0.001)。结论:两种计划相比较,宫颈癌术后正向调强放疗计划靶区剂量分布较好,OAR受照体积和剂量更低,适合在没有开展逆向调强放疗的单位推广应用。

Objective:To compare the dosimetric difference between three dimensional conformal radio therapy(3DCRT)and forward intensity modulated radiotherapy after cervical cancer surgery.Methods:From September 2016 to October 2018,30 cases of cervical cancer patients admitted to our hospital who had undergone surgery and concurrent radiotherapy were selected to develop 3DCRT and forward intensity modulated radiotherapy plans respectively.The distribution differences of planned target area(PTV)and organs at risk(OAR)were compared by DVH.Results:The Dmax and Dmean of PTV in the forward Intensity regulation group were significantly lower than those in the 3DCRT group(P=0.001,P=0.002),and the Dmin and CI95%were significantly higher than those in the 3DCRT group(P=0.016,P<0.001);The Dmean of small intestine,rectum,bladder,bilateral femoral head and other OAR in the positively regulated group were all lower than those in the 3DCRT group(P=0.004,P<0.001),and the exposed volume V40 and V45 of 40Gy and 45Gy in the high-dose area were also significantly lower than those in the 3DCRT group(P<0.001).Conclusion:Compared with the two plans,the dose distribution in the target area of the forward Intensity modulated radiotherapy plan after cervical cancer surgery is better,and the irradiated volume and dose of OAR are lower,which is suitable for the promotion and application in units that do not carry out the Reverse Intensity Modulated Radiotherapy.