宫颈癌三维放射治疗的新进展

基于CT、MRI、PET图像的三维后装治疗计划系统的应用,提高了剂量计算的精确度和准确度.宫颈癌放疗时剂量优化、屏蔽、多通道施源器及调强放疗技术的应用,有效地降低了正常组织的受照剂量.腔内后装放疗时,微型热释光片体内剂量测量是预测直肠并发症的有效指针,施源器的固定对确保剂量的准确性具重要意义.基于CT、MRI和光束扫描的凝胶三维剂量仪是目前三维剂量核实的主要手段,PET影像在宫颈癌的腔内后装治疗和体外调强放疗中的作用日益突出.

New Development of 3-D Radiation Therapy for Cervical Cancer

The application of 3-D treatment planning system based on CT?MRI?PET images has increased the precision and accuracy in dose calculation of after-loading brachytherapy. The application of dose optimization, shielding, multi-channel applicator and intensity modulated radiation therapy (IMRT) can effectively reduce the dose to normal tissues of patients with cervical cancer. During high-dose-rate brachytherapy for patients with cervical cancer, in vivo dosimetry using miniature TLD is a good predictor of late rectal complications, and the immobilization of applicator is of great importance for the target volume dose distribution. The 3-D gel-dosimetry based on the optical-computed tomography, computed tomography or MR scanning has become the main measure for the verification of 3-D dose distribution of high-dose-rate brachytherapy in gynecology. The PET images have a more and more important role in IMRT and brachytherapy for patients with cervical cancer.