【摘要】 目的 探讨宫颈癌盆腔适形放疗时靶区及直肠剂量分布与受照射体积的关系。方法 选取2006年9月～2006年12月收治的宫颈癌Ⅱa～Ⅲb患者共45例，分别进行不同方式的盆腔体外照射(传统对穿野照射、四野盒式照射、四斜野和五野照射)的剂量分布比较，观察靶区直肠受照射体积与剂量分布的关系。结果 宫颈癌盆腔适形放疗之四野对穿模式与其他模式及普通二野照射模式比较，其CTV剂量分布稍差，但能够满足治疗需求;接受照射的直肠体积内D90、D80、D50等剂量分布存在明显差异(P<0.05)，仅D30差异不大;四野对穿模式显示出直肠接受剂量与受照体积呈反向相关关系。结论 宫颈癌选择适形放疗能够使直肠接受辐射剂量的体积缩小，剂量减少。
【关键词】 宫颈癌;适形放疗;剂量分布;靶区;直肠
Relation of pelvic 3DCRT target with rectal dose distribution
and irradiation volume in cervical cancerLIU Zi1, YANG Yunyi1, WANG Ruihua1, WANG Juan1, MA Qingyong2
(1. Specialty of Radiotherapy for Womens Tumor; 2. Department of
Hepatobiliary Surgery, the First Affiliated Hospital, Medical School of
Xian Jiaotong University, Xian 710061, China)ABSTRACT: Objective To investigate the relation of pelvic threedimensional conformal radiotherapy (3DCRT) target with rectal dose distribution and irradiation volume in cervical cancer. Methods In 45 patients with cervical cancer (Ⅱa-Ⅲb) treated in our department from September to December 2006, we compared rectal dose distribution in different treatment plans: conventional radiation, 4field box radiation, 4field oblique radiation and 5field radiation, and studied the relationship between rectal irradiation volume and dose in the target area. Results Compared with that of the other models, the dose distribution of CTV in 3DCRT was relatively poor although it could satisfy the demand of treatment; dose distribution of D90, D80 and D50 in the radiated rectum differed significantly (P<0.05), but not D30. In the 4field box model, the irradiation dose had a reverse correlation with the volume received by the rectum. Conclusion Conformal radiotherapy for cervical cancer can decrease the dose and volume of irradiation received by the rectum.
KEY WORDS: cervical cancer; conformal radiotherapy; dose distribution; target; rectum
百余年来，宫颈癌的放射治疗始终在其综合治疗中占有极其重要的地位。近10余年来，随着放疗技术的不断更新和进步，作为一种精确
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