發(fā)布時(shí)間：2018-05-21 03:20

  本文選題：前列腺癌 + 調(diào)強(qiáng)放射治療�。� 參考：《臨床腫瘤學(xué)雜志》2016年09期

【摘要】：目的探討前列腺癌調(diào)強(qiáng)放療(IMRT)中直腸充盈狀態(tài)對(duì)靶區(qū)及危及器官(OAR)的影響。方法選取15例局限期前列腺癌IMRT患者,在直腸充盈和排空狀態(tài)下采集2次盆腔定位CT圖像,由同一高年資放療醫(yī)師勾畫靶區(qū)及OAR(如直腸、膀胱、股骨頭)后,由同一高年資放療物理師在相同處方劑量下行調(diào)強(qiáng)放療計(jì)劃設(shè)計(jì)。將2種直腸充盈狀態(tài)下的靶區(qū)和OAR劑量學(xué)參數(shù)進(jìn)行分析和配對(duì)t檢驗(yàn)。結(jié)果當(dāng)定位和實(shí)際治療時(shí)直腸體積一致(排空或充盈狀態(tài)),直腸不同體積狀態(tài)對(duì)靶區(qū)、膀胱及股骨頭劑量學(xué)參數(shù)無統(tǒng)計(jì)學(xué)差異(P0.05)。當(dāng)出現(xiàn)本試驗(yàn)假設(shè)的CT定位時(shí)為直腸排空狀態(tài)而實(shí)際治療時(shí)為直腸充盈狀態(tài),放療靶區(qū)的平均劑量、均勻指數(shù)、適形指數(shù)差異具有統(tǒng)計(jì)學(xué)意義(P0.05);直腸受照射劑量增加,直腸平均劑量、V50和V70增加56%、58%和288%(P0.05);膀胱及股骨頭劑量學(xué)參數(shù)則不受直腸狀態(tài)的影響(P0.05)。結(jié)論前列腺癌IMRT治療期間直腸保持充盈狀態(tài)一致能保證放療計(jì)劃得到很好的執(zhí)行,反之當(dāng)定位與放療期間直腸充盈狀態(tài)不一致時(shí),放療靶區(qū)及直腸劑量學(xué)將出現(xiàn)明顯差異。
[Abstract]:Objective to investigate the effect of rectal filling state on target area and OARs in IMRTs of prostate cancer. Methods 15 patients with localized prostate cancer (IMRT) were selected. Two pelvic localization CT images were collected under rectal filling and emptying. The target area and Oar (such as rectum, bladder, femoral head) were drawn by the same senior radiotherapy physician. The IMRT program is designed by the same senior radiation physicist with the same prescription dose. The target area and OAR dosimetric parameters of two rectal filling states were analyzed and matched t test. Results the rectal volume was consistent with that of actual treatment (emptying or filling state). There was no significant difference in dosimetric parameters of the target area, bladder and femoral head between different rectal volume states (P 0.05). The difference of average dose, uniform index and conformal index of the target area of radiotherapy was statistically significant (P 0.05) when the CT location was assumed to be rectal emptying and the actual treatment was rectal filling, and the dose of rectal irradiation was increased, and there was no significant difference in the mean dose, uniform index and conformal index of the target area of radiotherapy (P 0.05). The average rectal doses of V _ (50) and V _ (70) were increased by 56% and 2888% respectively, while the dosimetric parameters of bladder and femoral head were not affected by rectal state (P 0.05). Conclusion the consistent state of rectal filling during IMRT therapy for prostate cancer can ensure that the radiotherapy plan is carried out well. Otherwise, there will be significant difference in radiotherapy target area and rectal dosimetry when the location is not consistent with the rectal filling state during radiotherapy.
【作者單位】： 南京軍區(qū)福州總醫(yī)院放療科;南京軍區(qū)福州總醫(yī)院醫(yī)務(wù)部;
【基金】：福建省青年基金資助項(xiàng)目(2016J05198)
【分類號(hào)】：R737.25;R730.55

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