宫颈癌保骨髓调强放疗的剂量学分析。
A dosimetric analysis of intensity-modulated radiation therapy with bone marrow sparing for cervical cancer.
机构信息
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
出版信息
Anticancer Res. 2014 Sep;34(9):5091-8.
BACKGROUND/AIM: The purpose of the present study was to compare intensity-modulated radiation therapy (IMRT) plan with (Bone Marrow Sparing (BMS) - IMRT) or without (normal-IMRT) an intention of avoiding bone marrow in order to minimize treatment-related toxicity.
PATIENTS AND METHODS
Computed tomography (CT) images of 10 consecutive postoperative cervical cancer patients were used. All patients were already treated by normal-IMRT. BMS-IMRTs were created for this study and dose-volume histogram parameters were compared.
RESULTS
Both planning target volume (PTV) D95% and D97% were statistically lower in BMS-IMRT than normal-IMRT, however, the difference was lower than 3%. There were no statistical differences between BMS-IMRT and normal-IMRT in the mean value of rectum V30Gy, V50Gy; bladder V45Gy, V50Gy; Bowel V35Gy, and V50Gy. Both in whole pelvic bone (WPB) and inner cavity of pelvic bone (ICPB), the mean value of V10Gy, V30Gy, and V40Gy of BMS-IMRT were statistically lower than that of normal-IMRT.
CONCLUSION
Both lower and higher dose for WPB as well as ICPB were effectively lowered by BMS-IMRT.
背景/目的：本研究旨在比较调强放疗（IMRT）计划，包括（骨髓保护（BMS）-IMRT）或不（常规-IMRT）旨在避免骨髓，以最大程度地减少治疗相关毒性。
患者和方法
使用 10 例连续的术后宫颈癌患者的计算机断层扫描（CT）图像。所有患者均已接受常规-IMRT 治疗。为这项研究创建了 BMS-IMRT，并比较了剂量-体积直方图参数。
结果
BMS-IMRT 的计划靶区（PTV）D95%和 D97%均明显低于常规-IMRT，但差异低于 3%。BMS-IMRT 与常规-IMRT 之间直肠 V30Gy、V50Gy 的平均值、膀胱 V45Gy、V50Gy 无统计学差异；Bowel V35Gy 和 V50Gy。在全骨盆骨（WPB）和骨盆骨内腔（ICPB）中，BMS-IMRT 的 V10Gy、V30Gy 和 V40Gy 的平均值均明显低于常规-IMRT。
结论
BMS-IMRT 可有效降低 WPB 和 ICPB 的低剂量和高剂量。
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