ObjectiveTo compare the radiation dose distribution in irradiated target area and organs at risk among conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy in Graves' ophthalmopathy patients. MethodsThirty patients with Grave's ophthalmopathy treated between January 2010 and December 2012 were included in this study.CT scan was performed to obtain images of each patients; three-dimensional planning system (3D-TPS) was done to design conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy for each patient.Then, we counted the standard deviation of study parameters for each radiotherapy technique, and the results were compared among the three groups. ResultsAverage irradiation dose in target area of patients accepting conventional irradiation, conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05).V95 and the conformity index values of conformal irradiation and semi-field conformal irradiation therapy were better than those of the conventional irradiation therapy (P < 0.001), while no significant difference between conformal irradiation and semi-field conformal irradiation therapy was detected (P > 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in eye lens, while patients accepting semi-field conformal irradiation therapy got the lowest irradiation dose in eye lens, and the differences were significant (P < 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in pituitary, while cumulative irradiation dose in pituitary in patients accepting conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05). ConclusionsConformal irradiation and semi-field conformal irradiation techniques are superior to conventional irradiation technique, with a better target conformal degree and higher does distribution in target area, as well as a lower radiation dose in normal tissues surrounding target area.Semi-field conformal irradiation technique has a better performance than conformal irradiation therapy in eye lens protection.
目的:探討宮頸癌體外放射治療加后裝腔內治療的療效和放射反應。方法:對76例宮頸癌患者均采用體外放射治療加60Co 后裝腔內治療臨床資料進行回顧性分析。結果:全組 5年總生存率為 63.7%,Ⅰ期生存率為88.9%,Ⅱ期為 71.9%,Ⅲ期為48.1%,Ⅳ期為 20.0%。10年總生存率為 31.6%,Ⅰ期生存率為 53.3%,Ⅱ期為33.3%,Ⅲ期為 22.0%,Ⅳ期為 0.0%,經Log Rank法檢驗各期生存率有顯著差異(Plt;0.01)。放射治療后發生陰道粘連 9例(11.8%),放射性膀胱炎 6例(7.9%),放射性直腸炎13例(17.1%)。放射性直腸炎按 RTOG 晚期放射損傷分級方案分級,1級7例(53.8%),2級4例(30.8%),3級 2例(15.4%),4級 0例(0.0%)。結論:體外放射治療加60Co后裝腔內治療宮頸癌療效肯定,副作用少。但如何進一步提高生存率,盡可能減少放射反應仍是今后研究的方向。