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目的 :研究宫颈癌术后7野调强放疗计划与常规4野放疗计划(4野箱式照射)对危及器官的保护,并分析比较两种计划所产生的急性放射反应。方法:选取本院50例患者,其中25例为已行调强放疗,确定为调强组;另25例为已行常规放疗,确定为常规组。调强组同时设计常规4野模拟计划,与调强计划进行比较,做剂量学研究;同时,调强组与常规组进行急性反应的比较研究。结果:调强计划中达到46 Gy剂量包含临床靶区(CTV)体积显著>常规4野计划(P<0.05)。调强计划46 Gy包绕小肠、直肠、膀胱及骨髓的体积显著<4野计划(P<0.05)。调强组的1、2级恶心呕吐(P=0.002)、腹泻(P=0.048)、白细胞下降(P=0.02)、血红蛋白下降(P=0.005)明显少于4野常规组。结论 :调强计划较常规计划对保护危及器官具有明显剂量学优势,可以明显减少急性放射损伤。
OBJECTIVE: To study the protection of organs endangered by radiation intensified 7 Gynecomastia after radiotherapy and 4 radiotherapy radiotherapy (conventional radiotherapy) in 4 patients with cervical cancer and to analyze and compare the acute radiation response of the two plans. Methods: Fifty patients in our hospital were selected. Twenty-five of them were treated with intensity modulated radiotherapy and were treated with IMRT. The other 25 patients were treated with routine radiotherapy and were determined as routine. Tiangong group at the same time design conventional 4-field simulation plan, compared with the strengthening program to do dosimetric studies; the same time, the transfer group and the conventional group acute response to a comparative study. RESULTS: The 46 Gy dose achieved in the intensity-modulated program contained a significant volume of clinical target volume (CTV)> routine 4-field program (P <0.05). The volume of 46 Gy surrounding the intestine, rectum, bladder and bone marrow augmented by 46 Gy was significantly reduced (P <0.05). Grade 1, 2 nausea and vomiting (P = 0.002), diarrhea (P = 0.048), leukopenia (P = 0.02) and hemoglobin decrease (P = 0.005) were significantly less in the ITA group than those in the 4 routine group. CONCLUSIONS: The IMR program has obvious dosimetric advantages over routine programs for protecting endangered organs and can significantly reduce acute radiation damage.