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目的探讨膀胱充盈度对宫颈癌术后放疗靶区照射剂量的影响。方法选择2013年6月至2014年6月间收治的宫颈癌术后需行调强放疗患者30例,在膀胱充盈状态和排空状态行计算机断层扫描(CT)检查,对膀胱不同状态下的临床靶体积(CTV)、计划靶体积(PTV)、膀胱、直肠、小肠及股骨头的体积变化及平均照射剂量进行比较。结果 (1)膀胱处于充盈状态的膀胱体积明显大于处于排空状态的体积,差异有统计学意义(P<0.05);而CTV、CPV、直肠、小肠及股骨头的体积相比较,差异无统计学意义(P>0.05)。(2)膀胱处于充盈状态时对膀胱及小肠的照射剂量明显低于膀胱排空时,差异有统计学意义(P<0.05);而CTV、CPV、直肠及股骨头照射剂量在膀胱处于充盈状态与排空状态时的差异无统计学意义(P>0.05)。结论在膀胱处于充盈状态下,对宫颈癌术后患者进行调强放疗,可明显减少膀胱及小肠的照射剂量,对膀胱及小肠产生一定的保护作用,有一定的临床应用价值。
Objective To investigate the effect of bladder filling on the radiation dose of postoperative radiotherapy for cervical cancer. Methods Thirty patients undergoing IMRT after cervical cancer surgery between June 2013 and June 2014 were selected. CT scan was performed in the state of bladder filling and emptying, Clinical target volume (CTV), planned target volume (PTV), bladder, rectum, small intestine and femoral head volume changes and the average irradiation dose were compared. Results (1) The volume of bladder in the state of bladder filling was significantly larger than that in the state of emptying (P <0.05), while there was no statistical difference in the volume of CTV, CPV, rectum, small intestine and femoral head Significance (P> 0.05). (2) The dose of bladder and small intestine was significantly lower than bladder emptying when the bladder was in a state of fullness (P <0.05); while the doses of CTV, CPV, rectum and femoral head were in the state of bladder filling There was no significant difference with emptying state (P> 0.05). Conclusion In the state of bladder filling, IMRT of postoperative patients with cervical cancer can significantly reduce the irradiation dose of the bladder and small intestine, and have a certain protective effect on the bladder and small intestine, which has certain clinical value.