膀胱容量变化对宫颈癌放疗中肿瘤体积及参考点位置的影响

发布时间：2018-07-26 13:43

【摘要】：目的:分析膀胱不同容量对宫颈癌大体肿瘤体积(GTV)、中心点及体表参考点位置的影响,为勾画靶区提供参考。方法:选取IIB~IIIB期宫颈癌患者17例,分别在膀胱充盈及排空状态下行模拟定位CT扫描,由同一位医生勾画膀胱不同容量下肿瘤GTV,比较充盈状态下(GTVF)与排空状态下(GTVE)肿瘤体积大小、中心点三维坐标及体表参考点三维坐标的差异,分析参考点位置变化与膀胱容量的相关性。结果:宫颈肿瘤GTVF与GTVE的体积分别为(70.42±30.29)cm3、(71.66±30.15)cm3,两者比较差异无统计学意义(P=0.236)。膀胱充盈与排空状态下,GTV中心点X轴坐标分别为-6.00±12.37、-6.34±11.94(P=0.21),Y轴分别为-423.37±142.27、-427.40±139.13(P=0.01),Z轴分别为-52.82±14.05、-51.46±12.04(P=0.35)。膀胱充盈与排空状态下体表参考点X轴的坐标分别为-12.02±18.43、-11.96±18.40(P=0.86),Y轴的坐标分别为-377.49±136.76、-378.28±135.84(P=0.43),Z轴坐标分别为74.60±20.10、68.55±19.75(P=0.02)。参考点在Z轴方向的位移与膀胱容量呈正相关(P=0.001)。结论:膀胱充盈状态对宫颈肿瘤GTV大小无明显影响,对宫颈肿瘤中心点及体表参考点位置均有影响。膀胱不同容量下宫颈肿瘤GTV的位移以头足方向为著,而体表参考点的位移在前后方向更明显。
[Abstract]:Objective: to analyze the effect of bladder volume on the position of (GTV), center point and body surface reference point in gross tumor volume of cervical cancer, and to provide reference for drawing target area. Methods: seventeen patients with cervical cancer in IIB~IIIB stage were examined by simulated localization CT under filling and emptying of bladder respectively. The tumor volume of (GTVF) in filling state was compared with that of (GTVE) in emptying state, and the tumor volume under different volume of bladder was drawn by the same doctor. The difference between the three dimensional coordinates of center point and body surface reference point was analyzed, and the correlation between the change of reference point position and bladder capacity was analyzed. Results: the volumes of GTVF and GTVE were (70.42 卤30.29) cm 3 and (71.66 卤30.15) cm 3, respectively. Under the condition of bladder filling and emptying, the X-axis coordinates of the central point of GTV were -6.00 卤12.37 ~ -6.34 卤11.94 (P ~ (0.21) and -423.37 卤142.27 ~ -427.40 卤139.13 (P ~ (0.01) ~ -52.82 卤14.05-51.46 卤12.04 (P ~ (0.35), respectively. Under the condition of bladder filling and emptying, the coordinates of the X axis of the body surface reference point were -12.02 卤18.43 ~ 11.96 卤18.40 (P ~ (0.86) ~ (-377.49 卤136.76) ~ (-378.28 卤135.84) (P ~ (0.43) ~ (74.60 卤20.10) ~ (68.55) 卤19.75 (P ~ (0.02) respectively. The displacement of reference point in Z axis was positively correlated with bladder capacity (P0. 001). Conclusion: the filling state of bladder has no effect on the size of GTV in cervical neoplasms, but on the position of center point and body surface reference point of cervical tumor. The displacement of GTV in cervix neoplasms with different bladder volume was in the direction of head and foot, but the displacement of body surface reference point was more obvious in the front and back directions.
【作者单位】：山东中医药大学附属医院妇产科;山东省肿瘤医院放疗科;
【分类号】：R737.33

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