直肠癌术后容积旋转调强和三维适形放疗的疗效比较

目的]探讨直肠癌术后容积旋转调强(VMAT)和三维适形放疗(3DCRT)的剂量和疗效.方法]本院接受直肠癌手术的80例患者,根据术后放疗计划的不同随机分为A,B两组,A组给予术后VMAT放疗计划,B组给予3DCRT放疗计划,比较两组放疗剂量、治疗效果以及副作用.结果]A组最大吸收剂量(Dmax)、平均吸收剂量(Dmean)、最小吸收剂量(Dmin)和剂量均匀指数(HI)显著低于B组,靶区剂量适形度指数(CI)显著高于B组,且差异有显著性(P＜0.01),而两组95％体积受照射剂量(V9s％)差异无显著性(P＞0.05);A组在小肠、膀胱的Dmax、Dmean、50％体积受照射剂量(V50)值,左、右股骨头Dmean值上与B组比较差异具有显著性(P＜0.01);A组治疗时间显著短于B组,机器调数显著低于B组(P＜0.01);A组总缓解率70％,而B组则为65％,两组相比较差异无显著性(P＞0.05);A组总不良反应率为52.5％,显著低于B组的75％(P＜0.05).结论]直肠癌术后放疗治疗过程中,VMAT和3DCRT效果均较显著,但VMAT放疗更具计量学上精准、毒副作用小、治疗时间短的优势,临床治疗意义显著.

Comparison of Dose,Curative Rates,and Side Effects between Two Radiotherapy Plans (VMAT and 3DCRT) after Rectal Cancer Operation

Objective]To explore the differences in dose,curative rates,and side effects between volumetric modulated arc therapy (VMAT) and three dimensional conformal radiation therapy (3DCRT) after rectal cancer operation.Methods]Eighty patients with rectal cancer who underwent operation in our hospital were randomly divided into the VMAT group (A) and 3DCRT group (B) according to different postoperative radiotherapy plans.The dose,curative rates,and side effects of radiotherapy were compared between the two groups.Results] The values of Dmax,Dmean,Dmin,and HI (hompgenecity Index) in the A group were significantly lower than those in the B group,while the value of CI (Conformity Index) was significantly higher (P ＜0.01).The difference in V95 ％ between the two groups was not significant (P ＞0.05).There were significant differences in the values of Dmax,Dmean,and V50 in the small intestine and bladder between the two groups(P ＜0.01),the Dmean values in the left and right femoral heads also showed significant differences(P ＜0.01).The treatment time of group A was significantly shorter than that of group B and the hop count of body was significantly lower than that of group B (P ＜0.01).The total remission rate in group A was 70％,while in group B was 65％ (P ＞0.05).The total incidence of adverse reactions in group A (52.5 ％) was significantly lower than that in group B (75 ％) (P ＜0.05).Conclusion] During the process of radiotherapy after rectal cancer operation,the effects of both VMAT and 3DCRT are significant.However,the former is more consistent with metrology,and side effects are few,with short treatment time.It is of clinical significance.