实用肿瘤学杂志 ›› 2020, Vol. 34 ›› Issue (3): 232-236.doi: 10.11904/j.issn.1002-3070.2020.03.008

• 临床应用 • 上一篇    下一篇

超声膀胱容量监测技术在宫颈癌术后调强放疗中的应用价值

秦凯1, 程熠1, 袁响林1, 简丹妮2, 张菁1, 黄乐1   

  1. 1.华中科技大学同济医学院附属同济医院肿瘤科(武汉 430030);
    2.华中科技大学同济医学院附属协和医院耳鼻喉科
  • 收稿日期:2020-02-01 修回日期:2020-03-12 发布日期:2020-06-30
  • 作者简介:秦凯,男,(1984-),硕士,主治医师,从事妇科肿瘤及常见恶性肿瘤综合治疗的研究
  • 基金资助:
    湖北省卫生健康委科研项目(编号:WJ2019M118)

Application value of utrasound bladder volume monitoring technology in intensity modulated radiotherapy for cervical cancer after operation

QIN Kai1,CHENG Yi1,YUAN Xianglin1,JIAN Dan′ni2,ZHANG Jing1,HUANG Le1   

  1. 1.Department of Oncology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;
    2.Department of Otolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology
  • Received:2020-02-01 Revised:2020-03-12 Published:2020-06-30

摘要: 目的 探讨超声膀胱容量监测技术在宫颈癌术后调强放疗(IMRT)中的应用价值。方法 选择2018年10月—2019年10月在本院接受根治术后IMRT的宫颈癌患者56例,采用随机数字表法分为观察组和对照组,各28例。观察组采用超声膀胱容积测量仪监测膀胱容量,对照组采用医生口头指令和患者主观感觉膀胱充盈程度的方式。比较两组患者三维方向靶区移位误差、均匀性指数(HI)、适形度指数(CI)的差异,以及主要危及器官膀胱、小肠、直肠和股骨头受照体积百分比,再比较两组放疗期间出现的肠道不良反应。结果 观察组头脚和腹背方向的位移误差均显著低于对照组(P<0.001),但两组左右方向位移误差的差异无统计学意义(P>0.05)。观察组HI显著小于对照组(P<0.05),但两组CI差异无统计学意义(P>0.05);观察组膀胱、小肠的受照体积百分比显著小于对照组(P<0.05),观察组直肠、股骨头的受照体积百分比虽小于对照组,但两组差异无统计学意义(P>0.05);两组腹泻发生率的差异无统计学意义(P>0.05),但对照组患者出现腹泻的时间早于观察组。结论 在宫颈癌术后IMRT中采用超声膀胱容量监测技术来维持膀胱充盈程度的一致性,可减少靶区位移误差,增加靶区勾画的精确性,保证有效的靶区照射剂量,且在一定程度上保护了危及器官的生理功能,减轻放疗反应,应在临床推广应用。

关键词: 超声膀胱容量监测, 宫颈癌, 调强放疗, 靶区, 危及器官

Abstract: Objective The Objective of this study was to explore the application value of ultrasonic bladder volume monitoring technology in intensity modulated radiotherapy(IMRT)after operation of cervical cancer.Methods A total of 56 patients with cervical cancer who underwent IMRT after radical operation in our hospital from October 2018 to October 2019 were selected and divided into the observation and control groups with a random number table method,28 cases in each group.The patients in the observation group were monitored the bladder volume by the ultrasonic bladder volume meter,and the patients in the control group were instructed orally by doctors to feel subjectively the degree of bladder filling.The difference of three-dimensional target displacement error,homogeneity index(HI),conformability index(CI)and the percentage of irradiated volume of bladder,small intestine,rectum and femoral head were compared between patients in the observation and control groups.The intestinal adverse reactions during radiotherapy were also compared between patients in two groups.Results The displacement errors in the head,foot and ventral directions in the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.001),but the displacement errors in the left and right directions of the two groups was no differences between patients in the two groups(P>0.05).The HI in the observation group was significantly lower than that in the control group(P<0.05),but there was no differences in CI between patients in the two groups(P>0.05);the percentage of irradiated volume of the bladder and small intestine in the observation group was significantly smaller than that in the control group(P<0.05),but there was no differences in the percentage of irradiated volume of rectum and femoral head between patients in the two groups(P>0.05).There was no difference in the incidence of diarrhea between patients in the two groups(P>0.05),but the time of diarrhea in the control group was earlier than that in the observation group.Conclusion The use of ultrasonic bladder volume monitoring technology to maintain the consistency of bladder filling in IMRT after cervical cancer surgery can reduce the displacement error of target area,increase the accuracy of target area delineation,ensure the effective radiation dose of the target area,protect the physiological function of endangered organs at a certain extent,and reduce the response to radiotherapy,it should be promoted and applied in clinical practice.

Key words: Ultrasound bladder volume monitoring, Cervical cancer, Intensity modulated radiotherapy, Target area, Organ at risk

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