摘要
目的比较Manchester与Fletcher-suit Delclos(FSD)施源器在宫颈癌患者后装放疗中的剂量学差异。方法回顾性分析73例国际妇产科联盟(FIGO)分期为ⅡA~ⅢB期的宫颈癌患者资料,分析采用Manchester与FSD施源器各施行1次近距离后装放疗后的剂量分布,然后利用t检验分析两种施源器在所有宫颈癌患者及不同分期宫颈癌患者中的剂量学差异。评价指标包括:高危临床靶区的D_(100)、D_(90),治疗时长,小肠、膀胱和直肠的D_(2cc)。结果采用Manchester与FSD施源器的所有患者靶体积分别为(39.06±15.54)、(40.84±15.56)cm^(3)(P=0.49);在靶区D_(90)无显著性差异时,采用Manchester施源器对患者阴道前壁的剂量覆盖较好,对阴道后壁的覆盖较差,其靶区D_(100)高于FSD施源器(P<0.01);直肠D_(2cc)低于FSD施源器(P<0.01),而两组间放疗时长、膀胱与小肠D_(2cc)差异无统计学意义。结论Manchester施源器具有更好的阴道前壁剂量覆盖度,并在一定程度上可以更好地保护直肠,可为腔内后装放疗施源器的选择提供一定的临床参考。
Objective To compare the cervical cancer patients′dosimetry difference in brachytherapy between Manchester and Fletcher-suit Delclos(FSD)applicator.Methods There were 73 cervical cancer patients with stageⅡA-ⅢB.The data of dose distribution in the patients after brachytherapy with Manchester and FSD applicator were retrospectively analyzed.Then,the t-test was used to analyze the dosimetry differences between the two applicators in all patients with cervical cancer and the patients with different stages of cervical cancer respectively.Evaluation indicators include:the D_(100) and D_(90) of CTV-high,treatment time and the D_(2cc) of small intestine,bladder and rectum.Results The target volumes of all patients with Manchester and FSD applicators were(39.06±15.54)cm^(3) and(40.84±15.56)cm^(3),respectively(P=0.49).When there was no significant difference in the D_(90) of the target between the two groups,with the Manchester applicator,the dosage coverage of the anterior vaginal wall was better,while the posterior vaginal was poor.The D_(100) of the target was higher than that with the FSD applicator(P<0.01).The D_(2cc) of rectum was lower than that with the FSD applicator(P<0.01).While the treatment time and the D_(2cc) of bladder and small intestine had no significant difference between the two groups respectively.Conclusion The Manchester applicator had a better dosage coverage of the anterior vaginal wall and could be better to protect the patient′s rectum to a certain extent.This study could provide some clinical reference for the choice of applicator.
作者
李恒
黄顺平
陈永红
LI Heng;HUANG Shunping;CHEN Yonghong(Department of Oncology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 401336,China)
出处
《重庆医学》
CAS
2021年第24期4213-4217,4222,共6页
Chongqing medicine
基金
国家自然科学基金项目(81972851)。
