宫颈癌术后3D-CRT和IMRT的剂量学比较

目的：比较宫颈癌术后的三维适形放疗（3D-CRT）和调强放射治疗（IMRT）放射治疗计划的剂量学差异。方法：使用Elekta公司的PrecisePLAN Release2.11计划系统设计常规四箱形野（3D-CRT）和调强放疗（IMRT）计划。通过剂量-体积直方图比较二者的放射物理参数,评价其应用价值。结果：IMRT计划中靶区平均剂量略高于3D-CRT计划中的相应值,其靶区适形度明显占优。同时,IMRT计划中的膀胱、直肠、小肠、股骨头等危险器官受到的平均剂量低于3D-CRT计划中的相应值,除右股骨头受到的平均剂量差异没有统计学意义,其它数据的差异都具有统计学意义。结论：对于宫颈癌术后患者的放射治疗,IMRT技术在保证肿瘤放射剂量的同时最大限度地减少了危险器官的照射剂量,减少了并发症的发生,应该更广泛地应用于临床。

Dosimetry Comparison of 3-dimensional Conformal Radiation Therapy and Intensity Modulated Radiation Therapy Plans for Cervical Carcinoma after Radical Surgery

Objective：To compare dosimetry of 3-dimentional conformal radiotherapy（3D-CRT） and intensity-modulated radiation therapy（IMRT） plans for cervical carcinoma after radical surgery.Methods：In 15 patients,3D-CRT and IMRT plans were performed,and plans were compared according to dose-volume histogram.Results：The mean doses for gross tumor volume（GTV） in IMRT plan and the conformity index were better than those in 3D-CRT plan.Also,the mean doses of bladder,rectum,bowel and left femoral head in IMRT plan were statistically lower than those in 3D-CRT plan. Conclusion： In radiotherapy of cervical carcinoma after radical surgery, IMRT not only ensures the dose for GTV, but also limits the dose for the organs at risk as could as possible, so that could reduce the incidence of complications. IMRT should be more widely applied in clinic practice.