摘要
目的探索高龄宫颈癌患者术后快速容积旋转调强(Rapid Arc)计划和5野调强放疗(five-field intensity modulated radiotherapy,5F-IMRT)计划的剂量学比较及疗效观察。方法选取102例高龄宫颈癌患者,均行宫颈癌根治术,依据随机数字表法,将患者分为观察组和对照组,每组51例。对照组给予Rapid Arc计划,观察组给予5F-IMRT计划。比较两组患者计量学、3年生存率及不良反应等指标。结果观察组患者靶区剂量靶区平均剂量、靶区最大剂量和靶区最小剂量等指标明显高于对照组(P<0.05),而两组患者均匀指数和适形指数等指标差异无统计学意义(P>0.05);观察组患者左股骨头和右股骨头V20(受照20 Gy体积百分比)、V30数值明显低于对照组(P<0.05),观察组患者直肠、小肠和膀胱V30(受照30 Gy体积百分比)、V40(受照40 Gy体积百分比)和V50(受照50 Gy体积百分比)数值明显高于对照组(P<0.05);观察组患者机器跳数和治疗时间明显低于对照组(P<0.05);治疗期间,两组患者均出现恶心呕吐、白细胞减少、放射性肠炎和放射性膀胱炎等不良反应事件,但两组患者不良反应发生率差异无统计学意义(P>0.05)。所有患者均获得随访,观察组患者3年生存率为86.27%(44/51),对照组患者3年生存率为82.35%(42/51),两组3年生存率差异无统计学意义(P>0.05)。结论宫颈癌术后放疗应用Rapid Arc计划可在获得等同剂量分布、降低危及器官受量的基础上优化直线加速器,缩短患者治疗时间,值得临床进一步推广和研究。
Objective To explore the dosimetry and efficacy of Rapid Arc plan and 5-field intensity-modulated radiotherapy(5F-IMRT)plan in postoperative radiotherapy for cervical carcinoma in elderly patients.Methods A total of 102 elderly patients with cervical cancer were selected.All patients underwent radical resection of cervical cancer,and they were divided into observation group(n=51)and control group(n=51)according to the random number table method.Patients in the control group were given Rapid Arc plan,while patients in the observation group were given 5F-IMRT plan.The indexes of dosimetry,3-year survival rate and adverse reactions were compared between two groups.Results The average target dose,maximum target dose and minimum target dose in the observation group were significantly higher than those in the control group(P<0.05),but there was no significant difference in uniformity index and conformal index between two groups(P>0.05).The values of percentage of volume receiving more than 20 Gy(V20)and V30 of the left and right femoral head in the observation group were significantly lower than those in the control group,while the V30,V40 and V50 values of rectum,small intestine and bladder in the observation group were significantly higher than those in the control group(P<0.05).The number of machine jumps and duration of treatment in the observation group were significantly lower than those in the control group(P<0.05).During the treatment,adverse reactions such as nausea and vomiting,leukopenia,radiation enteritis and radiation cystitis occurred in both groups,but there was no significant difference between two groups(P>0.05).All patients were followed up,and the 3-year survival rate was 86.27%(44/51)in the observation group and 82.35%(42/51)in the control group(P>0.05).Conclusion The application of Rapid Arc technology in postoperative radiotherapy for cervical cancer can optimize the linear accelerator and shorten the duration of treatment on the basis of obtaining the same dose distribution and reducing the orga
作者
陆泓
吴霞
张璨
LU Hong;WU Xia;ZHANG Can(Department of Gynecological Oncology, the Affiliated Tumor Hospital of Nantong University, Jiangsu Province, Nantong 226361, China)
出处
《河北医科大学学报》
CAS
2021年第7期813-817,共5页
Journal of Hebei Medical University
基金
南通市卫生和计划生育委员会科研项目(QA2019027)。
关键词
宫颈肿瘤
放射疗法
放射治疗剂量
terine cervical neoplasms
radiotherapy
radiotherapy dosage
