CERVIX REGRESSION AND MOTION DURING THE COURSE OF EXTERNAL BEAM CHEMORADIATION FOR CERVICAL CANCER
CERVIX REGRESSION AND MOTION DURING THE COURSE OF EXTERNAL BEAM CHEMORADIATION FOR CERVICAL CANCER
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DOI：
10.1016/j.ijrobp.2008.03.064
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发表时间：
2009-01-01
影响因子：
7
通讯作者：
Eifel, Patricia I.
中科院分区：
文献类型：
--
作者：
Beadle, Beth M.;Jhingran, Anuja;Eifel, Patricia I.
目的：探讨宫颈癌体外放化疗过程中宫颈运动和消退的程度。方法与材料：16例宫颈癌患者在常规放化疗前、中、后均行计算机断层扫描。计算子宫颈体积以确定子宫颈退化的程度。在两次扫描之间的质心和宫颈周长的变化被用来确定宫颈运动的大小。计算每个患者的最大子宫颈位置变化，并计算组的平均最大变化。结果：45 Gy外照射前后宫颈平均体积分别为97.0、31.9 cc；平均体积减少62.3%。宫颈质心在上下、前后和左右外侧的平均最大变化分别为2.1、1.6和0.82 cm。宫颈周长平均最大变化分别为上下2.3 cm和1.3 cm，前后1.7 cm和1.8 cm，左右外侧0.76 cm和0.94 cm。结论：宫颈癌放化疗患者盆腔内靶位置发生明显的干涉变化，与宫颈后退和内脏运动有关。在应用高适形外束辐射技术时，如果不考虑这些变化，理论上可能会造成对目标的剂量不足或对邻近关键结构的剂量过大。(C) 2009爱思唯尔公司
Purpose: To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer.Methods and Materials: Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group.Results: Mean cervical volumes before and after 45 Gy of external beam irradiation were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively.Conclusions: Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures. (C) 2009 Elsevier Inc.