High precision radiotherapy considering the risk of recurrence and complication for cervical cancer

本研究的目的是发展考虑复发和并发症风险的高精度放射治疗，促进宫颈癌的个体化治疗。主要研究内容包括原发灶的图像引导近距离放射治疗(IGBT)、盆腔淋巴结转移的控制、调强放射治疗(IMRT)与常规3D适形放射治疗的比较。对于形状不规则的肿块，常规用药和组织间针相结合的混合近距离放射治疗能有效地覆盖足够的剂量，同时节省直肠剂量。明确了调强放射治疗的盆腔控制量和小肠、骨盆骨剂量的节约作用。

The purpose of the study was to develop high precision radiotherapy considering the risk of recurrence and complication and to promote the personalized treatment for uterine cervical cancer. The major research included image-guided brachytherapy (IGBT) for primary tumor, control of pelvic lymph node metastases, and comparison of intensity-modulated radiotherapy (IMRT) with conventional 3D conformal radiotherapy.In the IGBT, increasing or decreasing of point A dose balanced sufficient dose between rectum and target. In case of irregular-shaped bulky tumor, hybrid brachytherapy consisting of conventional application and interstitial needle was effective to cover the tumor with sufficient dose while sparing the rectal dose. We also clarified the pelvic control dose and the sparing effect of small intestine and pelvic bone doses by IMRT.