前列腺癌调强放疗中直肠充盈状态对靶区及危及器官的影响

发布时间：2018-05-21 03:20

本文选题：前列腺癌 + 调强放射治疗　；参考：《临床肿瘤学杂志》2016年09期

【摘要】：目的探讨前列腺癌调强放疗(IMRT)中直肠充盈状态对靶区及危及器官(OAR)的影响。方法选取15例局限期前列腺癌IMRT患者,在直肠充盈和排空状态下采集2次盆腔定位CT图像,由同一高年资放疗医师勾画靶区及OAR(如直肠、膀胱、股骨头)后,由同一高年资放疗物理师在相同处方剂量下行调强放疗计划设计。将2种直肠充盈状态下的靶区和OAR剂量学参数进行分析和配对t检验。结果当定位和实际治疗时直肠体积一致(排空或充盈状态),直肠不同体积状态对靶区、膀胱及股骨头剂量学参数无统计学差异(P0.05)。当出现本试验假设的CT定位时为直肠排空状态而实际治疗时为直肠充盈状态,放疗靶区的平均剂量、均匀指数、适形指数差异具有统计学意义(P0.05);直肠受照射剂量增加,直肠平均剂量、V50和V70增加56%、58%和288%(P0.05);膀胱及股骨头剂量学参数则不受直肠状态的影响(P0.05)。结论前列腺癌IMRT治疗期间直肠保持充盈状态一致能保证放疗计划得到很好的执行,反之当定位与放疗期间直肠充盈状态不一致时,放疗靶区及直肠剂量学将出现明显差异。
[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.
【作者单位】：南京军区福州总医院放疗科;南京军区福州总医院医务部;
【基金】：福建省青年基金资助项目(2016J05198)
【分类号】：R737.25;R730.55

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