宫颈癌调强放疗中保护骨盆骨髓对血液毒性的影响

目的 观察宫颈癌患者调强放疗时保护骨盆骨髓对血液毒性的影响.方法 40例宫颈癌术后放疗患者随机分入研究组和对照组各20例,根据靶区勾画要求勾画临床靶区（CTV）及正常组织,观察组在放疗计划设计时按要求限制骨盆骨髓受照剂量和体积;对照组不予以限制骨盆骨髓受照剂量和体积.放疗前、放疗中每周及放疗结束时复查血常规.结果 观察组和对照组患者均未发生4级血液毒性反应;其4级以下血液学毒性发生率分别为50％和80％,差异有统计学意义（P＜0.05）.结论 宫颈癌调强放疗保护骨盆骨髓可以降低患者血液学毒性发生率.

Clinical observation of hematologic toxicity in intensity modulated radiotherapy for cervical cancer to restrict dosimetry of bone marrow irradiated

Objective To observe the blood toxicity of protecting the pelvic bone marrow in cervical cancer patients receiving intensity modulated radiation therapy.Methods 40 cervical cancer patients receiving postoperative radiotherapy were randomized into two groups：20 cases in the experimental group required limited doses and volume of pelvic bone marrow when the plan was designed,20 cases in the control group needed not.According to the principle of target delineation,all cases outlined the clinical target volume （CTV） and normal tissue.The blood routine examination was carried out before radiotherapy,per week during radiotherapy and at the end of radiotherapy.Results There was no grade 4 hematologic toxicity in the experimental group and control group,and the lower grade hematologic toxicity rates were 50 %and 80%,the difference of the two groups was statistically significant（P=0.47）.Conclusion Protection pelvic bone marrow can reduce the incidence of hematologic toxicity in patients with cervical cancer receiving intensity modulated radiation.