■局部晚期宫颈癌通常使用外部束放射治疗和近距离放射治疗的组合来治疗。放射治疗通常会导致阴道发病,这带来了一个重大问题。本研究旨在分析减少卵形体加载对剂量学的影响。
■我们分析了15例患者的45例基于CT的腔内近距离放射治疗计划。为45个应用程序创建了三个计划集:标准装载计划(A),卵形体加载减少的计划(B),和仅串联装载计划(C)。我们生成剂量-体积直方图并记录三个计划组的剂量体积参数。
■临床目标体积(CTV)的D90在三个计划集之间没有显示出显着差异(p=0.20)。A计划的平均D90值,B,C是8.15Gy,8.16Gy,和7.4Gy,分别。在D2cc膀胱中没有观察到统计学上的显着差异(p=0.09)(平均值:6.8Gy,6.5Gy,A计划为5.9Gy,B,C,分别)和D2cc乙状结肠(p=0.43)(平均值:2.8Gy,2.6Gy,和2.4Gy,分别)在三套计划中。然而,D2cc直肠的差异有统计学意义(p<0.001)(平均值:4Gy,3.3Gy,和1.8Gy,分别),以及阴道剂量点(p<0.001)。
■减少卵形体负荷显著降低了阴道剂量点和直肠的剂量,而不影响临床目标体积(CTV)的剂量。因此,在精心挑选的案例中,在高剂量率腔内近距离放射治疗后,可以考虑采用仅串联加载或减少卵形体加载,以最大程度降低阴道发病率.
UNASSIGNED: Locally advanced cervical cancer is frequently treated using a combination of external beam radiotherapy and brachytherapy. Radiotherapy often leads to vaginal morbidity, which poses a significant problem. This study aims to analyze the impact of reducing ovoid loading on dosimetry.
UNASSIGNED: We analyzed forty-five CT-based intracavitary brachytherapy plans from fifteen patients. Three plan sets were created for the 45 applications: a standard loading plan (A), a plan with reduced ovoid loading (B), and a tandem-only loading plan (C). We generated Dose-Volume Histograms and recorded dose volume parameters for the three plan sets.
UNASSIGNED: The D90 for the Clinical Target Volume (CTV) did not show significant differences among the three plan sets (p = 0.20). The average D90 values for plans A, B, and C were 8.15 Gy, 8.16 Gy, and 7.4 Gy, respectively. No statistically significant differences were observed in D2cc bladder (p = 0.09) (average values: 6.8 Gy, 6.5 Gy, and 5.9 Gy for plans A, B, and C, respectively) and D2cc sigmoid (p = 0.43) (average values: 2.8 Gy, 2.6 Gy, and 2.4 Gy, respectively) among the three plan sets. However, there was a statistically significant difference in D2cc rectum (p < 0.001) (average values: 4 Gy, 3.3 Gy, and 1.8 Gy, respectively), as well as in vaginal dose points (p < 0.001).
UNASSIGNED: Reducing ovoid loading significantly decreased the doses to vaginal dose points and the rectum without compromising the dose to the Clinical Target Volume (CTV). Therefore, in carefully selected cases, the adoption of tandem-only loading or reduced ovoid loading could be considered to minimize vaginal morbidity following high dose rate intracavitary brachytherapy.