Kobayashi Rei, Murakami Naoya, Chiba Takahito, Okuma Kae, Inaba Koji, Takahashi Kana, Kaneda Tomoya, Kashihara Tairo, Takahashi Ayaka, Shimizu Yuri, Nakayama Yuko, Kato Tomoyasu, Ito Yoshinori, Igaki Hiroshi
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Radiation Oncology, Showa University Hospital, Tokyo, Japan.
Adv Radiat Oncol. 2022 Feb 6;7(3):100918. doi: 10.1016/j.adro.2022.100918. eCollection 2022 May-Jun.
Hyaluronate gel has been injected as a spacer into the rectovaginal fossa and vesicouterine fossa during brachytherapy for patients with cervical cancer at our institution. The effect of hyaluronate gel injection (HGI) on dose-volume parameters was investigated in this study.
Between July 2008 to January 2020, a total of 104 patients (non-HGI group: 52 patients; HGI group: 52 patients) who underwent curative radiation therapy for cervical cancer were selected. The total doses of external beam radiation therapy and brachytherapy for high-risk clinical target volume (CTV) D, bladder D, and rectal D were converted to the equivalent dose in 2 Gy fractions (EQD2) and were analyzed for association with HGI.
Median CTV D (EQD2) in the non-HGI group was 76.0 Gy (63.7-99.5 Gy), and in the HGI group it was 79.4 Gy (52.6-97.5 Gy) ( = .017). The median bladder D and rectal D (EQD2) were 62.9 Gy and 56.0 Gy in the non-HGI group and 63.7 Gy and 54.8 Gy in the HGI group, which had no significant difference.
In cases with HGI, a significant CTV D dose increase was obtained with sufficient bladder and rectal doses suppression.
在我院，宫颈癌患者近距离放疗期间，已将透明质酸盐凝胶作为间隔物注入直肠阴道窝和膀胱子宫窝。本研究调查了透明质酸盐凝胶注射（HGI）对剂量体积参数的影响。
选取2008年7月至2020年1月期间共104例行宫颈癌根治性放射治疗的患者（非HGI组：52例患者；HGI组：52例患者）。将高危临床靶区（CTV）D、膀胱D和直肠D的外照射放疗和近距离放疗的总剂量转换为2 Gy分次的等效剂量（EQD2），并分析其与HGI的相关性。
非HGI组CTV D（EQD2）的中位数为76.0 Gy（63.7 - 99.5 Gy）,HGI组为79.4 Gy（52.6 - 97.5 Gy）（P = 0.017）。非HGI组膀胱D和直肠D（EQD2）的中位数分别为62.9 Gy和56.0 Gy，HGI组分别为63.7 Gy和54.8 Gy，差异无统计学意义。
在HGI的病例中，在充分抑制膀胱和直肠剂量的情况下，CTV D剂量显著增加。
