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宫颈癌计算机断层扫描引导下高剂量率腔内近距离治疗中危及器官分次间剂量变化的报告

Reporting of Inter Fraction Dose Variations of Organs at Risk in Computed Tomography-Guided High Dose Rate Intracavitary Brachytherapy in Carcinoma Cervix.

作者信息

Nandi Moujhuri, Pokala Neelima, Perumareddy Vaishnavi, Sarkar Sujata, Chanda Sudeep

机构信息

Department of Radiation Oncology, Meherbai Tata Memorial Hospital, Jamshedpur, Jharkhand, India.

出版信息

J Med Phys. 2022 Oct-Dec;47(4):394-397. doi: 10.4103/jmp.jmp_91_22. Epub 2023 Jan 10.

Abstract

Assess the interfraction dose variations of the organs at risk (OARs) in carcinoma cervix high dose rate (HDR) computed tomography (CT)-guided intra cavitary brachytherapy (ICBT). 120 CT scans of 40 patients who had undergone three fractions of ICBT (7 Gy/fr) were analyzed. Dose to Point A and the minimum doses to the volumes of 2, 1, and 0.1cc of bladder, rectum and sigmoid colon were recorded. Revised plans were generated in 20 patients. Paired -test was used to compare the difference in the means. Point "A" mean dose difference was statistically significant between the treated and revised plans. For bladder, the difference in means of dosage to all volumes, whilst for the rectum and sigmoid colon, the low volume dosage (0.1cc) was statistically significant. Absence of individualized planning would have resulted in underdosage of tumor and increased dosage of up to 30% to OARs. CT-guided ICBT should be implemented for each HDR fraction treatment.

摘要

评估宫颈癌高剂量率(HDR)计算机断层扫描(CT)引导下腔内近距离放射治疗(ICBT)中危及器官(OARs)的分次间剂量变化。分析了40例接受三次ICBT(7Gy/分次)治疗患者的120次CT扫描。记录A点剂量以及膀胱、直肠和乙状结肠2cc、1cc和0.1cc体积的最小剂量。为20例患者制定了修订计划。采用配对t检验比较均值差异。治疗计划和修订计划之间,A点平均剂量差异具有统计学意义。对于膀胱,所有体积的剂量均值存在差异,而对于直肠和乙状结肠,小体积剂量(0.1cc)具有统计学意义。缺乏个体化计划会导致肿瘤剂量不足,而OARs剂量增加高达30%。每次HDR分次治疗均应实施CT引导下的ICBT。

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Cancer of the cervix uteri.子宫颈癌。
Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:22-36. doi: 10.1002/ijgo.12611.
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High versus low-dose rate brachytherapy for cervical cancer.宫颈癌高剂量率与低剂量率近距离放射治疗
Gynecol Oncol. 2015 Mar;136(3):534-41. doi: 10.1016/j.ygyno.2014.12.038. Epub 2015 Jan 6.

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