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目的:探讨宫颈癌腔内后装治疗中危及器官的ICRU参考点剂量和体积剂量的关系。方法:回顾性分析2016年11月~2017年3月于河北省沧州中西医结合医院接受宫颈癌腔内后装治疗的19例患者的61个治疗CT图像,通过设计治疗计划,A点剂量归一,得出计算结果,并对膀胱和直肠的受照剂量进行评估。结果:膀胱的D_(ICRU)参考点的平均剂量为(3.48±0.67)Gy,D_(2cc)体积的平均剂量为(3.53±0.58)Gy。直肠的D_(ICRU)参考点的平均剂量为(3.19±0.85)Gy,D_(2cc)体积的平均剂量为(3.43±0.71)Gy。膀胱D_(2cc)与D_(ICRU)剂量平均值的比值为1.116,直肠D_(2cc)与D_(ICRU)剂量平均值的比值为1.081。膀胱Dmax平均剂量为(4.78±0.85)Gy,直肠D_(max)平均剂量为(3.78±0.29)Gy。膀胱和直肠的D_(ICRU)点剂量和D2CC体积剂量具有相关性(膀胱:rs=0.77,P<0.001;直肠:rs=0.69,P<0.001)。结论:在危及器官受量的评估中,由DVH图得出的体积剂量要高于ICRU参考点剂量,二维计划中ICRU参考点剂量并不能代表危及器官的实际最大受照剂量。
Objective: To investigate the relationship between ICRU reference dose and volumetric dose of endocrine-disrupted organ in cervical cancer. Methods: A retrospective analysis of 61 therapeutic CT images of 19 patients who underwent endovascular treatment of cervical cancer in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from November 2016 to March 2017 was conducted. The therapeutic dose was calculated at point A First, the calculation results were obtained, and the dose of the bladder and rectum were evaluated. RESULTS: The mean D_ (ICRU) reference point of bladder was (3.48 ± 0.67) Gy and the average dose of D_ (2cc) volume was (3.53 ± 0.58) Gy. The mean D_ (ICRU) reference point was (3.19 ± 0.85) Gy in the rectum and (3.43 ± 0.71) Gy in the D_ (2cc) volume. The ratio of bladder D_ (2cc) to D_ (ICRU) dose was 1.116, and the ratio of D_ (2cc) to D_ (ICRU) was 1.081. The mean dose of bladder Dmax was (4.78 ± 0.85) Gy and the average dose of rectum D max was (3.78 ± 0.29) Gy. Bladder and rectal D ICRD dose was correlated with D2CC volume dose (bladder: rs = 0.77, P <0.001; rectum: rs = 0.69, P <0.001). CONCLUSIONS: Volumetric doses derived from DVH maps are higher than ICRU reference dose estimates for endocrine-tolerant assessments, and the ICRU reference dose in two-dimensional programs does not represent the actual maximum dose at risk for the organ.