[1]常娟娟,李太平,康婉英,等.容积旋转调强与调强放疗在宫颈癌放疗中的应用及剂量学、安全性研究[J].陕西医学杂志,2024,(2):194-198.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.010]
　CHANG Juanjuan,LI Taiping,KANG Wanying,et al.Application,dosimetric and safety analysis of volumetric modulated arc therapy and intensity modulated radiation therapy in radiotherapy of cervical cancer[J].,2024,(2):194-198.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.010]
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容积旋转调强与调强放疗在宫颈癌放疗中的应用及剂量学、安全性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年2期
页码:
194-198
栏目:
临床研究
出版日期:
2024-02-05

文章信息/Info

Title:
Application,dosimetric and safety analysis of volumetric modulated arc therapy and intensity modulated radiation therapy in radiotherapy of cervical cancer
作者:
常娟娟; 李太平; 康婉英; 张 飞; 王光明
(阜阳市肿瘤医院放疗科,安徽 阜阳 236000)
Author(s):
CHANG Juanjuan; LI Taiping; KANG Wanying; ZHANG Fei; WANG Guangming
(Department of Radiotherapy,Fuyang Cancer Hospital,Fuyang 236000,China)
关键词:
宫颈癌;  容积旋转调强;  调强放疗;  剂量;  危及器官;  安全性
Keywords:
Cervical cancer;  Volumetric modulated arc therapy;  Intensity modulated radiation therapy;  Dose;  Organs-at-risk;  Safety
分类号:
R 737.33
DOI:
DOI:10.3969/j.issn.1000-7377.2024.02.010
文献标志码:
A
摘要:
目的:探究容积旋转调强放疗(VMAT)与调强放疗(IMRT)在宫颈癌根治术后放疗中的应用及剂量学、安全性。方法:选取宫颈癌根治后且拟行放疗的患者60例,根据随机数字表法将其分为VMAT组(30例)和IMRT组(30例),分别给予VMAT治疗与IMRT治疗,对比两组机器跳数、治疗计划执行时间、靶区适形度(CI)和均匀性指数(HI)、危及器官的剂量差异及不良反应等。结果:VMAT组在计划控制点多于IMRT组的情况下,其治疗时间仍短于IMRT组。通过Delta验证,VAMT组患者的3%/3 mm和4%/4 mm γ通过率低于IMRT组(均P<0.05)。VAMT组计划的CI记录与IMRT组比较无统计学差异(P>0.05),但与IMRT组相比,VAMT组的HI更接近于1,差异有统计学意义(P<0.05)。VAMT组直肠的V30、V40、V50低于IMRT组,VAMT组对骨盆、膀胱的V20、V30、V40低于IMRT组(均P<0.05); VAMT组和IMRT组发生胃肠道反应患者分别有9例(30.00%)、14例(46.67%); VAMT组和IMRT组发生膀胱反应的患者分别有3例(10.00%)、5例(16.67%),两组胃肠道、膀胱反应发生率比较均无统计学差异(均P>0.05)。两组疗效及随访期内复发或转移情况对比均无统计学差异(均P>0.05)。结论:在宫颈癌根治术后放疗时,VMAT治疗可时间缩短,且治疗效率及剂量学参数优于IMRT,可有效保护骨盆、直肠和膀胱,安全性好。
Abstract:
Objective:To investigate the application,dosimetric and safety differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in radiotherapy of cervical cancer after radical operation.Methods:Sixty patients who underwent radical operation for cervical cancer and planned to receive radiotherapy were selected,and randomly divided into the observation group(30 cases)and the control group(30 cases).The control group was treated with IMRT,while the observation group was treated with VMAT.The monitor unit,treatment plan execution time,Conformal Index(CI)and Homogeneity Index(HI)of target volume,organs-at-risk,and adverse reactions were compared between two groups.Results:In the case of planned control points of VMAT more than those of IMRT,the duration of VMAT was still shorter than that of IMRT.Delta validation found that the pass rates of 3%/3 mm and 4%/4 mm γ in VAMT group were lower than those in IMRT group(all P<0.05).The CI records of VAMT regimen were similar to those of IMRT(P>0.05).Compared with IMRT,HI of VAMT was closer to 1(P<0.05).Rectal V30,V40 and V50 in VAMT group were lower than those in IMRT group.V30,V40 and V50 of the pelvis and bladder in VAMT group were significantly lower than those in IMRT group(all P<0.05).There were 9(30.00%)and 14(46.67%)patients with gastrointestinal reactions in VAMT group and IMRT group,respectively.There were 3(10.00%)and 5(16.67%)patients with bladder reactions in VAMT group and IMRT groups,respectively.There were no statistically significant differences in the incidence rates of gastrointestinal reactions and bladder reactions between the groups(all P>0.05).There was no statistically significant difference between the two groups in terms of efficacy and recurrence/metastasis during the follow-up period(all P>0.05).Conclusion:In radiotherapy after radical operation for cervical cancer,the duration of VMAT is relatively short.In addition,the treatment efficiency and dosimetric parameters are better than IMRT.It also can effectively protect the pelvis,rectum and,bladder,with good safety.

参考文献/References:

[1] 钟亮,廖荣伟,刘清壮,等.调强适形放疗联合新辅助化疗治疗上下行型鼻咽癌疗效研究[J].陕西医学杂志,2020,49(8):964-968.
[2] 胡丽娟,张靖,周敏,等.容积旋转调强放疗与固定野调强放疗在保留卵巢的宫颈癌根治术后放疗中的剂量学研究[J].实用癌症杂志,2022,37(11):1851-1854.
[3] 黄宝添,林佩贤.周围型肺癌立体定向放射治疗靶区最高剂量对正常组织的影响[J].现代肿瘤医学,2022,30(12):2255-2259.
[4] 赵永亮,吴建亭,金建华,等.宫颈癌术后放疗不同体位膀胱充盈程度对危及器官的影响[J].中国医学物理学杂志,2021,38(1):11-14.
[5] 刘裕,方坚强,徐萍,等.容积旋转调强放疗联合三维后装腔内放疗治疗对局部晚期宫颈癌患者的近期疗效、不良反应及免疫功能的影响[J].中国性科学,2022,31(9):95-99.
[6] 林晓明,梁荣,陈兴贵,等.紫杉醇同期化疗联合后程超分割调强放疗在ⅢB期宫颈癌治疗中的临床研究[J].陕西医学杂志,2016,45(8):1003-1004,1005.
[7] GUO M F,ZHAO X J,HUANG Y,et al.The dosimetric and clinical comparison between helical tomotherapy and fixed-field intensity-modulated radiotherapy in radical irradiation for cervical cancer[J].International Journal of Radiation Research,2022,20(2):377-382.
[8] 林仲秋,罗祥美.《2010 NCCN宫颈癌临床实践指南》解读[J].国际妇产科学杂志,2010,37(1):72-73.
[9] 侯丽娟,翟建军.PAR1、PAR4在宫颈癌中的表达及临床意义[J].陕西医学杂志,2017,46(7):967-969,972.
[10] 吴艳芳,陈蕾.八珍汤加味联合放疗治疗中晚期宫颈癌疗效及对患者细胞免疫水平和营养状态的影响[J].陕西中医,2022,43(8):1052-1055.
[11] 管强.调强放疗联合化疗与单纯调强适形放疗治疗鼻咽癌的效果分析[J].中国临床实用医学,2016,9(1):8-11.
[12] 董莹.探讨贝伐单抗联合胸部VAMT治疗EGFR阴性Ⅲ期NSCLC患者的临床效果[J].中国保健营养,2019,29(31):112-113.
[13] 王玮,梅长文,宫尚明.比较宫颈癌IMRT和VMAT两种放疗计划的PTV及危及器官剂量学参数差异[J].临床和实验医学杂志,2022,21(24):2657-2660.
[14] 李钢,谭军文,贺先桃,等.固定铅门模式下控制点间距对乳腺癌容积旋转调强放射治疗计划剂量学的影响[J].医疗卫生装备,2022,43(11):48-53.
[15] 杨勤,李贵玲,陈秘,等.宫颈癌容积旋转调强与固定野九野调强计划对比研究[J].中国医师杂志,2015,17(4):501-505.
[16] 刘娜,刘子成,崔相利,等.肺癌立体定向放射治疗旋转容积调强计划控制点优化设计[J].中国医学装备,2022,19(3):11-16.
[17] 张静,蒋胜鹏,江波,等.左侧乳腺癌根治术后自动容积旋转调强放疗计划研究[J].中华肿瘤防治杂志,2021,28(10):753-758.
[18] LATALA A,FUJAK E,WALEWSKA A,et al.The comparison of VMAT test results for clinac 2300C/D and true beam accelerators[J].Medical Dosimetry:Official Journal of the American Association of Medical Dosimetrists,2020,45(3):457-466.
[19] 杨娜,孙毅,张建庆.容积旋转调强放疗与静态调强适形放疗在鼻咽癌患者中的应用及对甲状腺功能的影响[J].中国医药导报,2022,19(34):134-139.
[20] 许新明,刘琦,刘颖,等.宫颈癌术后七野固定调强放疗与容积旋转调强放疗计划剂量学对比研究[J].重庆医学,2022,51(17):2970-2975.
[21] SHI J G,YANG F J,JU X G,et al.Comparative study on dosimetry of VMAT and IMRT in assisted radiotherapy after radical resection of rectal cancer[J].Oncology Letters,2017,13(5):2971-2974.
[22] JODDA A,PIOTROWSKI T,URBANSKI B,et al.Relations between dose cumulated in organs at risk and treatment based on different image-guidance strategies of cervical cancer[J].Physica Medica,2019,57:183-190.
[23] 李国强,罗敬,郑志坚,等.容积旋转调强放疗联合同步化疗对中晚期宫颈癌的近期疗效评价[J].白求恩医学杂志,2017,15(2):141-143.
[24] 朱必清,武雅琴,韩晶晶,等.宫颈癌术后静态调强放疗与容积旋转调强放疗的比较[J].南京医科大学学报(自然科学版),2018,38(1):88-90.
[25] 时亮.加速器运行误差对宫颈癌容积旋转调强放疗的剂量学影响[J].智慧健康,2022,8(36):133-136,146.

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备注/Memo

备注/Memo:
基金项目:安徽省卫生健康委员会科研项目(AHWJ2021a049)
更新日期/Last Update: 2024-02-05