本文選題：宮頸癌　切入點：后裝治療　出處：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：分析膀胱在充盈和排空狀態(tài)下宮頸癌后裝治療中對膀胱及直腸受量的影響，為減少宮頸癌后裝治療后出現(xiàn)并發(fā)癥膀胱炎及直腸炎提供依據(jù)。 方法：選取20例完成盆腔外照射的FIGO分期為IIa期-IIIb期的宮頸癌患者，應(yīng)用荷蘭核Fletcher系統(tǒng)給予三管近距離照射，另外選取20例FIGO分期為Ib-IIa期的宮頸癌根治術(shù)后患者，，給予二管近距離照射。利用CT模擬定位，分別掃描排尿后及排尿后半小時膀胱充盈50ml以上的CT圖像。在膀胱排空狀態(tài)及充盈狀態(tài)下的CT圖像上勾畫危及器官（OAR）膀胱及直腸。分別制定膀胱排空及充盈狀態(tài)下的治療計劃，計劃處方劑量為600cGy/次，根據(jù)DVH圖評價危及器官劑量情況，以評價出正常組織劑量分布較好的宮頸癌近距離治療計劃。 結(jié)果：1、三管近距離照射膀胱在充盈50ml以上的狀態(tài)下，1cm3體積的膀胱受照劑量B-D1400±70（cGy）明顯大于膀胱排空狀態(tài)下1cm3體積的膀胱受照劑量B-D1332±65（cGy），具有統(tǒng)計學(xué)意義（P＜0.05）；2cm3體積的膀胱受照劑量B-D2362±63（cGy）明顯大于2cm3體積的膀胱排空狀態(tài)下膀胱受照劑量B-D2296±94（cGy），具有統(tǒng)計學(xué)意義（P＜0.05）；直腸受照劑量在膀胱排空及充盈兩種狀態(tài)下無明顯差別。 2、二管近距離照射膀胱在充盈50ml以上狀態(tài)下，1cm3體積的膀胱受照劑量b-D1395±55(cGy)明顯大于膀胱排空狀態(tài)下1cm3體積的膀胱受照劑量b-D1350±76（cGy），具有統(tǒng)計學(xué)意義（P＜0.05）；2cm3體積的膀胱受照劑量b-D2368±59（cGy）明顯大于膀胱排空狀態(tài)下2cm3體積的膀胱受照劑量r-D2315±63（cGy），具有統(tǒng)計學(xué)意義（P＜0.05）；直腸受照劑量在膀胱排空及充盈兩種狀態(tài)下無明顯差別。 結(jié)論：宮頸癌患者行腔內(nèi)近距離放療時，膀胱充盈狀態(tài)對膀胱受量存在影響。排空膀胱后可較好的保護膀胱，減少膀胱受照劑量。膀胱充盈狀態(tài)對直腸受量影響不大。
[Abstract]:Objective: to analyze the effect of bladder filling and emptying on bladder and rectum in order to reduce the complications of cystitis and proctitis.Methods: twenty patients with cervical cancer with FIGO staging of stage IIa-IIIb who had completed external pelvic irradiation were treated with three-tube brachytherapy using the Dutch nuclear Fletcher system, and 20 patients with FIGO staging as stage Ib-IIa after radical resection of cervical cancer were selected.Give two tubes of brachytherapy.Ct images of bladder filling with 50ml after urination and half an hour after urination were scanned by CT simulated localization.The bladder and rectum were delineated on CT images under bladder emptying and filling.The treatment plan under the condition of bladder emptying and filling was made, and the planned prescription dose was 600cGy/. According to the DVH map, the organ dose was evaluated to evaluate the close range treatment plan for cervical cancer with good dose distribution in normal tissues.緇撴灉:1,涓夌榪戣窛紱葷収灝勮唨鑳卞湪鍏呯泩50ml浠ヤ笂鐨勭姸鎬佷笅,1cm3浣撶Н鐨勮唨鑳卞彈鐓у墏閲廈-D1400鹵70(cGy)鏄庢樉澶т簬鑶

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