图像引导下的宫颈癌自适应调强放射治疗

目的：研究宫颈癌自适应调强放射治疗中的摆位误差对靶区和器官剂量变化影响。方法：选取本院自2012年3月-2014年3月间收治的40例自适应调强放射治疗宫颈癌患者，采用资料回顾性分析，分别采集三组首次摆位误差、摆位误差纠正后以及治疗后的CT图像，对X、Y、Z方向的偏移误差进行计算，分析摆位误差对靶区和器官剂量分布影响。结果：经回顾性CT诊断分析，纠正后摆位误差与首次系统随机摆位误差之间差异显著（P＜0.05），具有统计学意义；治疗后摆位误差与纠正后摆位误差比较差异不显著（P＞0.05），无统计学意义。由于摆位误差造成宫颈癌原发瘤平均剂量变化为-2.57%-3.56%，膀胱平均剂量变化为-12.27%-3.78%，股骨头平均剂量变化为-7.04%-8.45%，直肠平均剂量变化范围为-10.52%-12.82%，小肠平均剂量变化范围为-3.07%-15.33%。结论：采用图像引导技术对于宫颈癌患者进行摆位误差纠正，可引起靶区和器官剂量变化，采用图像引导技术可以使得靶区以及周围正常组织器官剂量分布更加准确，有效提升放疗精度，从而提升放疗质量。

Image-Guided Adaptive Radiation Therapy of Intensity-Modulated Radiation for Cervical Cancer

To study the influence of setup error in adaptive radiation therapy of intensity-modulated radiation on dosage changes of target region and organs. Method： 40 patients with adaptive radiation therapy of intensity-modulated radiation admitted by our hospital from March 2021 to March 2014 were selected as study objects. The influence of setup error influence of setup error were analyzed by the calculation of set errors in x, y, z directions on the CT pictures. The CT pictures were taken respectively at the time when the error firstly showed, after the error was corrected and after the treatment. Result：From the retrospective analysis of the CT diagnosis, it can be found that the setup error after correction was significantly different from the first systematic random setup error （P＜0.05）, which was statistically＆nbsp;significant. The setup error after treatment was not significantly different from the setup error after correction （P＞0.05）,which was not statistically significant. The change range of average dosage of primary tumor caused by setup error was -2.57% to 3.56%, the bladder-12.27%to 3.78%, the formal head-7.04%to 8.45%, the rectum-10.52%to 12.82%, the small intestine-3.07%to 15.33%. Conclusion：Correcting the setup error of cervical cancer patients by the image-guided technique can cause the dosage change of the target region and organs. The image-guided technique can make the dosage distribution of target regions and organs around the target region become more accurate. It can increase the accuracy and quality of radiation.