宫颈癌根治术后并发无症状盆腔淋巴囊肿调强放疗的临床研究

目的： 探讨宫颈癌根治术后并发无症状淋巴囊肿（pelvic lymphocyst，PL）患者进行调强放疗（intensity modulated radiotherapy，IMRT）的可行性。方法：2015年1月至2016年2月期间我科收治的宫颈癌根治术后具有放疗指征的患者共92例，根据模拟定位计算机断层扫描（computed tomography，CT）时是否发现PL分为实验组（有PL且PL直径≤6cm，46例）和对照组（无PL，46例）。实验组临床靶区（clinical target volume，CTV）勾画将全部PL包括在内，两组均采用同样的IMRT技术制定治疗计划，通过剂量体积直方图（dose volume histogram，DVH）及放疗期间周围危及器官（organ at risk，OAR）小肠、直肠、膀胱的急性反应分析PL对IMRT的影响，并观察实验组PL在放疗结束时及放疗结束后3月的转归情况。〖HTH〗结果：〖HTSS〗实验组CTV体积明显大于无PL组，差异具有统计学意义（P<0.05）。在IMRT放疗方式中，两组小肠、直肠、膀胱受照剂量体积差异无统计学意义（P>0.05）。两组小肠、直肠、膀胱的急性放射性反应差异无统计学意义（P>0.05）。实验组PL放疗结束时有效率达60.61%，放疗后3个月达89.32%。结论：宫颈癌根治术后并发无症状PL患者及时给予术后IMRT不增加放疗期间小肠、直肠、膀胱的急性放射性反应，同时可以治愈PL。

Clinical Study of Intensity-modulated Radiotherapy to Treat Asymptomatic Pelvic Lymphocyst after Radical Operation for Cervical Cancer

Objective: To explore the feasibility of intensity-modulated radiotherapy (IMRT) to treat the asymptomatic pelvic lymphocyst(PL) appeared after radical operation for cervical cancer.Methods: From January 2015 to February 2016,92 cervical cancer patients who had the post operative indications of radiotherapy were enrolled in this study.Patients were divided into the experimental group (PL were detected and with the diameter less than or equal to 6cm,46 cases) and the control group (PL were not detected,46 cases) according to whether asymptomatic PL were detected by the simulation computed tomography (CT).PL were all included in the clinical target volume (CTV) of the experimental group,and the same technology of IMRT treatment plans were applied in these two groups.The influence of PL on IMRT was analyzed by means of dose volume histogram (DVH) and the acute radiation reaction of organ at risk (OAR) such as acute radiation enteritis,cystitis and proctitis.In addition,the outcome of PL was observed at the end of radiotherapy and 3 months after radiotherapy.Results: The volume of CTV in the experimental group was significantly larger than that in the control group (P<0.05).The irradiation dose volume for small intestine,rectum and bladder of the two groups were of no significant difference(P>0.05).Also no significant difference was observed of the incidence of acute radiation reaction of small intestine,rectum,bladder between these two groups (P>0.05).The curative efficacy of PL in the experimental group was 60.61% at the end of radiotherapy and 89.32% 3 months after radiotherapy.Conclusion: For the asymptomatic PL appeared after radical operation for cervical cancer patients,timely IMRT treatment is effective without the increasing of acute radiation reaction of small intestine,rectum,and bladder.