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Abstract：
The influence of a hydrogel spacer (HS) on seminal vesicle (SV) displacement in prostate radiotherapy was examined in the present study. A total of 20 patients with prostate cancer, who received intensity-modulated radiation therapy (IMRT), were enrolled. Computed tomography and magnetic resonance imaging were performed before and after HS insertion within the peripheral space for IMRT planning. Before and after HS insertion, The SV was delineated, and the amount of SV displacement was evaluated. Large SV cranial displacements (≥0.50 cm) were observed in 25% of patients. A HS lateral distribution of ≥1.00 cm in the upper two slices (midgland + superior) influenced the SV cranial displacements (P<0.01) and was associated with large SV cranial displacements (≥0.5 cm) (P<0.01). The HS cranial distribution in the upper slices did not influence SV cranial displacements (P=0.16). In addition, any HS lateral distribution of ≥1.00 cm in all slices did not induce the SV lateral and anterior-posterior displacements (P=0.50 and 0.70, respectively). In conclusion, SV cranial displacement was influenced by HS lateral distribution of ≥1.00 cm in the upper two slices. Therefore, when the sigmoid colon or small bowel is depressed in rectovesical excavation and SV needs to be included in the target volume, HS insertion should be performed carefully.
摘要：
本研究检查了水凝胶间隔物（HS）对前列腺放射治疗中精囊（SV）位移的影响。共有20名前列腺癌患者，谁接受了调强放射治疗（IMRT），已注册。在周围空间内插入HS之前和之后进行计算机断层扫描和磁共振成像以进行IMRT计划。插入HS之前和之后，SV被划定，并对SV位移量进行了评价。在25％的患者中观察到大的SV颅骨位移（≥0.50cm）。上两片（中腺+上）HS侧向分布≥1.00cm影响SV颅位移（P<0.01），并与大的SV颅位移（≥0.5cm）有关（P<0.01）。上部切片中的HS颅骨分布不影响SV颅骨位移（P=0.16）。此外,所有切片中≥1.00cm的HS侧向分布均未引起SV侧向和前后位移(分别为P=0.50和0.70).总之,SV颅骨位移受上部两片中HS侧向分布≥1.00cm的影响。因此,当乙状结肠或小肠在直肠膀胱挖掘中被抑制并且SV需要被包括在目标体积中时,应仔细进行HS插入。
