1.2周咏春.ppt

Dose distribution and DVH in CT IGBT LOGO 局部晚期宫颈癌CT图像引导下后装治疗直肠晚期反应与DVH参数的关系 第四军医大学西京医院放疗科 周咏春 Background GYN GEC ESTRO Recommendation - tumor C. Haie-Meder et al., Radiother Oncol 74, 235 ( 2005) R. Potter et al., Radiother Oncol 78, 67 (2006) D90 for HR-CTV ：75 - 90 Gy (EQD2) GYN GEC ESTRO Recommendation - OAR R. Potter et al., Radiother Oncol 78, 67 (2006) D2cc (EQD2, cumulative) Rectum 75 Gy Sigmoid 75 Gy Bladder 90 Gy Wide use of 3D IGBT 2011 survey S. Pavamani et al., Brachytherapy 10, 345 (2011) Current situation 3D IGBT was not widely used in developing countries. Most of the data in recommendations were from MRI. Few data was reported in CT IGBT, especially in China. Aim Based on GYN GEC-ESTRO Recommendation DVH and rectal LSE of CT IGBTin China. Materials and methods Patients: 2008.07-2009.12, 144 consecutive cases (FIGO : IB2-IIIB) Treatment: EBRT+ brachytherapy ± concurrent chemotherapy CT IGBT: 6 or 7 Gy × 4-7 fractions DVH analysis: D90 for HR CTV and D2cc, D1cc, D0.1cc for rectum LSE scoring: LENT-SOMA (Late Effects in Normal Tissues) -Subjective - Objective -Management -Analytic Results 3-year actuarial rates of OS, LC and DFS 81.4% 91.4% 74.5% LC: 67%-86% for 2D 3-year actuarial rates of rectal LSE Total： 62.2 % in 111 alive LC cases Grade 1： 28.8% Grade 2： 19.8% Grade 3： 13.5% RTOG: 2.1% 2D: 13-26% Clinical variable na for grade 0-1 n for grade 2-3 P b Age 52 (27–74) c ＜55 48 20 0.27 ≥55 26 17 FIGO stage (Ib- IIIb) Ib- II 13 2 0.077 III 61 35 Histological diagnosis Squamous cell carcinoma 111 Maximum tumor dimension (cm) ≤5 51 24 0.667 ＞5 23 13 Patient and Tumor Characteristics a No. of patients b