摘要
目的:比较容积旋转调强(Volume Modulated Arc Therapy,VMAT)与固定野调强(Intensity-Modulated Radiation Therapy,IMRT)治疗晚期宫颈癌的效果。方法:回顾性收集2022年3月-2024年3月期间本院收治的81例接受放疗治疗的晚期宫颈癌患者的临床资料。根据放疗方案的不同将患者分为VMAT组(容积弧形调强放射治疗,n=41)与IMRT组(固定野调强适形放射治疗,n=40)。收集比较两组的临床疗效、靶区剂量学差异、危及器官的剂量学差异以及不良反应发生情况。结果:两组的临床疗效无显著差异(P>0.05)。VMAT组的计划靶区(Planning Target Volume,PTV)的适形指数(Conformity Index,CI)显著高于IMRT组,淋巴结病变计划大体肿瘤靶区(Planning Gross Tumor Volume of nodal disease,PGTVnd)的均匀性指数(Homogeneity Index,HI)显著低于IMRT组(P<0.05)。两组的PTV、PGTVnd的最大剂量(Maximum Dose,Dmax)、最小剂量(Minimum Dose,Dmim)、平均剂量(Mean Dose,Dmean)均无显著差异(P>0.05)。VMAT组膀胱接受20Gy照射的体积(Volume receiving 20 Gray,V20Gy),直肠V20Gy,小肠V20Gy、V30Gy、V40Gy,左右侧股骨V10Gy、V20Gy、V30Gy、V40Gy、V50Gy、Dmean均显著低于IMRT组(P<0.05);其余指标比较差异无统计学意义(P>0.05)。两组的放射性损伤发生率无显著差异(P>0.05)。结论:VMAT与IMRT的临床效果相当,但相较于IMRT,VMAT具有更好的均匀性与适形度,且能更好的保护危及器官。
Objective:To compare the effects of volumetric intensity-modulated therapy(Volume Modulated Arc Therapy,VMAT)and fixed-field intensity-modulated therapy(Intensity-Modulated Radiation Therapy,IMRT)in the treatment of advanced cervical cancer.Methods:The clinical data of 81 patients with advanced cervical cancer who received radiotherapy and were admitted to our hospital from March 2022 to March 2024 were retrospectively collected.Patients were divided into the VMAT group(volumetric arc modulated radiotherapy,n=41)and the IMRT group(fixed-field intensity-modulated conformal radiotherapy,n=40)according to different radiotherapy regimens.Collect and compare the clinical efficacy,dosimetric differences in the target area,dosimetric differences in organs at risk,and the occurrence of adverse reactions between the two groups.Results:There was no significant difference in the clinical efficacy between the two groups(P>0.05).The Conformity Index(CI)of the Planning Target Volume(PTV)in the VMAT group was significantly higher than that in the IMRT group,and the Homogeneity Index(HI)of the Planning Gross Tumor Volume of nodal disease(PGTVnd)in lymph node lesions was significantly lower than that in the IMRT group(P<0.05).There was no significant difference in the maximum dose(Dmax),minimum dose(Dmim),and mean dose(Dmean)of PTV and PGTVnd between the two groups(P>0.05).The volume receiving 20 Gray(V20Gy)of the bladder,V20Gy of the rectum,V20Gy,V30Gy,V40Gy of the small intestine,and V10Gy,V20Gy,V30Gy,V40Gy,V50Gy,and Dmean of the left and right femurs in the VMAT group were significantly lower than those in the IMRT group(P<0.05).The differences in other indicators were not statistically significant(P>0.05).There was no significant difference in the incidence of radiation damage between the two groups(P>0.05).Conclusion:The clinical effects of VMAT and IMRT are comparable.However,compared with IMRT,VMAT has better homogeneity and conformal performance,and can better protect organs at risk.
作者
梁爽
樊涛
党俊明
郭炎
Liang Shuang;Fan Tao;Dang Jun-ming;Guo Yan(Department of Radiotherapy,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)
关键词
宫颈癌
容积旋转调强
固定野调强
晚期
临床疗效
Cervical cancer
Volume Modulated Arc Therapy
Intensity-Modulated Radiation Therapy
Late stage
Clinical efficacy
