摘要
目的比较局部晚期宫颈癌三维适形近距离治疗中膀胱、直肠不同充盈状态下OAR的ICRU参考点剂量与体积剂量参数之间关系。方法MRI引导宫颈癌三维适形近距离治疗患者31例，共96分次，在TPS中确定ICRU直肠、膀胱参考点，记录其剂量，分别与直肠、膀胱体积剂量参数进行比较，配对t检验其差异。结果膀胱DICRU小于膀胱D0.1cm^3，和D1cm^3，（P=0．000、0．000），大于D5cm^3和D10cm^3（P=0．000、0．000），与D2cm^3相近（P=0．345）。膀胱充盈状态下，膀胱的DICRU小于膀胱D2cm^3。直肠DICRU小于直肠D0.1cm^3和D1cm^3（P=0．000、0．002），大于D5cm^3和D10cm^3（P=0．000、0．000），与D2cm^3相近（P=0．058）。膀胱、直肠ICRU参考点剂量与各自的D2cm^3呈正相关。膀胱体积≥200cm^3,ICRU膀胱参考点会低估膀胱的D2cm^3剂量。直肠体积≥37cm^3，ICRU直肠参考点会低估直肠的D2cm^3，剂量；直肠体积〈37cm^3，ICRU直肠参考点会高估直肠的D2cm^3剂量。结论在三维适形近距离治疗中采用D2cm^3，作为评价OAR指标是基本安全的，但当膀胱、直肠处于排空状态时还需分别参考膀胱、直肠ICRU点剂量。
Objective To investigate the correlation between ICRU reference point dose and dosevolume parameters of organs at risk （OARs） under different bladder and rectal filling status in three- dimensional conformal brachytherapy for locally advanced cervical cancer. Methods A total of 31 patients who received magnetic resonance imaging-guided three-dimensional conformal brachytherapy for cervical cancer in 96 fractions were enrolled. The ICRU rectal and bladder reference points were determined in the treatment planning system, and the doses at these points were recorded and compared with the dose-volume parameters of the rectum and bladder. The paired t-test was used to analyze the differences between them. Results Bladder DICRU was lower than bladder D01 cm^3 and D1cm^3 （P= 0. 000 and 0. 000）, higher than bladder D5 cm^3 and D10cm^3 （P= 0. 000 and 0. 000）, and similar to bladder D2 cm^3 （P= 0. 345）. Under the bladder filling status, bladder DlcRu was lower than D2em3. Rectal DICRU was lower than rectal D0.1cm^3 and D1cm^3 （P= 0. 000 and 0. 002）, higher than rectal D5 cm^3 and D10 cm^3 （ P= 0. 000 and 0. 000）, and similar to rectal D2 cm^3 （P=0. 058）. The ICRU bladder and rectal reference point doses were positively correlated with corresponding D2 cm^3. In the case of bladder volume ≥ 200 cm^2, the ICRU bladder reference point dose underestimated bladder D2 ore3. In the case of rectal volume ≥ 37 cm^3 , the ICRU rectal reference point dose overestimated rectal D2 cm^3. Conclusions In three-dimensional conformal brachytherapy, it is generally safe to use D2 cm^3 as an index to evaluate OARs, but when the bladder or rectum is in an empty status, the ICRU bladder or rectal reference point doses should be considered.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2016年第5期483-488,共6页
Chinese Journal of Radiation Oncology
基金
吉林省科技厅项目（20090458）
吉林省卫生计生委项目（2014ZC054）
吉林省科技厅白求恩专项（20160101079JC）
吉林大学横向课题（2015373）
