摘要
目的探讨体重指数(BMI)对宫颈癌术后调强放疗患者临床靶区(CTV)扩边宽度及CTV-内靶区(ITV)扩边界值的影响。方法按BMI的不同,将218例宫颈癌术后调强放疗患者分为对照组(BMI﹤24 kg/m2,n=102)和研究组(BMI≥24 kg/m2,n=116)。采用瓦里安Eclipse治疗计划系统勾画靶区,瓦里安直线加速器进行治疗,并使用机载影像系统检查和图像验证系统重新勾画靶区,比较两组患者CTV扩边宽度及CTV-ITV扩边界值。结果两组宫颈癌患者临床分期比较,差异均无统计学意义(P﹥0.05)。两组患者CTV前界和双侧界的最大边距比较,差异均无统计学意义(P﹥0.05);研究组患者CTV后界最大边距明显大于对照组患者,差异有统计学意义(P﹤0.01)。研究组患者前界、后界和双侧界的扩边界值均明显大于对照组患者,差异均有统计学意义(P﹤0.01)。结论 BMI可明显影响宫颈癌患者CTV后界扩边宽度,应扩大BMI较大宫颈癌患者的CTV后界最大边距和CTV-ITV扩边界值,以保证靶区不会被遗漏。
Objective To investigate the effect of body mass index (BMI) on the clinical target volume (CTV) and clinical target volume internal target volume (CTV-ITV) margin expansion using postoperative intensity-modulated radiotherapy in patients with cervical cancer.Method According to the different level of BMI,218 patients with cervical cancer receiving postoperative intensity-modulated radiotherapy were allocated to control group (BMI<24 kg/m^2,n=102) or study group (BMI≥24 kg/m^2,n=116),respectively.The Varian Eclipse treatment system was used to delineate the target area,and the Varian linear accelerator was applied to treat the two groups of patients,besides,the on-board imaging system and verification system were utilized used to re-delineate the target area to compare the CTV and CTV-ITV margin expansion.Result There were no significant differences in the clinical stage between the two groups of cervical cancer patients (P>0.05).No evident differences regarding the maximal surface distance of CTV anterior and bilateral margin between the two groups (P>0.05).The maximal surface distance of the CTV posterior margin was significantly larger in study group than that in the control group,and the difference was of statistical significance (P<0.01).In the study group, the anterior,posterior and bilateral margin expansion were larger than those in control group,indicating statistically significant difference (P<0.01).Conclusion BMI has a significant effect on the patient’s posterior margin expansion of CTV, so the maximal surface distance of posterior CTV and CTV-ITV margin should be expanded in patients with higher BMI in to order not to miss any target volume.
作者
何丽琳
宋锐
HE Lilin;SONG Rui(Department of Oncology,Tianmen First People’s Hospital,Tianmen 431700,Hubei,China;Department of Radiotherapy,Tianmen First People’s Hospital,Tianmen 431700,Hubei,China)
出处
《癌症进展》
2019年第7期831-833,共3页
Oncology Progress
关键词
临床靶区
扩边宽度
宫颈癌
调强放疗
内靶区
CTV
margin expansion
cervical cancer
intensity-modulated radiotherapy
ITV
