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目的:探讨宫颈癌根治术后并发无症状淋巴囊肿(pelvic lymphocyst,PL)患者进行调强放疗(intensity-modulated radiotherapy,IMRT)的可行性。方法:2015年1月至2016年2月期间我科收治的宫颈癌根治术后具有放疗指征的患者共92例,根据模拟定位计算机断层扫描(computed tomography,CT)时是否发现PL分为实验组(有PL且PL直径≤6cm,46例)和对照组(无PL,46例)。实验组临床靶区(clinical target volume,CTV)勾画将全部PL包括在内,两组均采用同样的IMRT技术制定治疗计划,通过剂量体积直方图(dose volume histogram,DVH)及放疗期间周围危及器官(organ at risk,OAR)小肠、直肠、膀胱的急性反应分析PL对IMRT的影响,并观察实验组PL在放疗结束时及放疗结束后3月的转归情况。结果:实验组CTV体积明显大于无PL组,差异具有统计学意义(P<0.05)。在IMRT放疗方式中,两组小肠、直肠、膀胱受照剂量体积差异无统计学意义(P>0.05)。两组小肠、直肠、膀胱的急性放射性反应差异无统计学意义(P>0.05)。实验组PL放疗结束时有效率达60.61%,放疗后3个月达89.32%。结论:宫颈癌根治术后并发无症状PL患者及时给予术后IMRT不增加放疗期间小肠、直肠、膀胱的急性放射性反应,同时可以治愈PL。
Objective: To investigate the feasibility of intensity-modulated radiotherapy (IMRT) in patients with cervical lymphadenectomy after cervical cancer radical resection. Methods: From January 2015 to February 2016, 92 patients with radiotherapy indications underwent radical gastrectomy in our department were enrolled in this study. Based on the results of simulated computed tomography (CT) Group (PL and PL diameter ≤ 6cm, 46 cases) and control group (no PL, 46 cases). The clinical target volume (CTV) was plotted in the experimental group to include all the PLs. The same IMRT technique was used to develop the treatment plan in both groups. The dose volume histogram (DVH) and peripheral organ damage during radiotherapy (organ at risk, OAR) small intestine, rectum and bladder. The effect of PL on IMRT was analyzed. The outcome of PL in the experimental group at the end of radiotherapy and after the end of radiotherapy was observed. Results: The CTV volume of the experimental group was significantly larger than that of the non-PL group (P <0.05). In IMRT radiotherapy, there was no significant difference in dose volume between the two groups (P> 0.05). The two groups of small intestine, rectum, bladder acute radioactive differences were not statistically significant (P> 0.05). Experimental group PL radiotherapy at the end of the effective rate of 60.61%, 3 months after radiotherapy up to 89.32%. Conclusion: The prompt administration of postoperative IMRT to patients with asymptomatic PL after radical operation for cervical cancer does not increase the acute radiation reaction of small intestine, rectum and bladder during radiotherapy and can cure PL at the same time.