宋春慧　　赵伟

[關键词] 宫颈癌;放射治疗;照射剂量;治疗靶区;影像学技术

[中图分类号] R737.33          [文献标识码] B          [文章编号] 1673-9701（2021）14-0095-04

Study on the correlation between imaging and pathology of cervical cancer radiotherapy target area

SONG Chunhui1   ZHAO Wei2

1.Department of Oncology， Zaozhuang Mining Group Central Hospital， Zaozhuang  277000， China; 2.Department of Surgery， Zaozhuang Mining Group Central Hospital， Zaozhuang   277000， China

[Abstract] Objective To analyze the correlation between imaging and pathology of cervical cancer radiotherapy target area. Methods A total of 61 patients with cervical cancer admitted to our hospital from January 2019 to January 2020 were taken as the research objects. They received radiotherapy and concurrent chemotherapy and underwent CT， MRI examinations during the period. The correlation of imaging and pathology of the treatment target area were analyzed and summarized. Results The tumor volume of patients was （77.04±3.91） cm3 before treatment （51.19±2.47） cm3 after treatment， there was significant difference before and after the treatment（P<0.05）. The clinical target volume was（564.26±31.48） cm3 before treatment and （424.91±20.75） cm3 after treatment，there was significant difference before and after the treatment（P<0.05）. The small intestinal dose of the patient during the second half of the radiation was significantly increased， and the GTV and rectal dose were significantly reduced，with significant difference（P<0.05）. MRI gross tumor target volume （GTVMRI） mean value was （13.55±10.24） cm3， CT gross tumor target volume（GTVCT） mean value was （18.45±11.09） cm3， and pathological gross tumor target area（GTVpath） mean value was（9.55±8.74） cm3. Correlation analysis showed that GTVMRI was correlated with GTVpath（r=0.935， P=0.000）; GTVCT was correlated with GTVpath（r=0.834，P=0.005）. Conclusion The tumor volume and clinical target volume of patients after treatment will reduced more significantly than before treatment， indicating that the imaging technology of the treatment target area can evaluate the efficacy. In the process of cervical cancer radiotherapy， the radiation range and dose should be adjusted reasonably to ensure the effect of radiotherapy. Correlation studies have confirmed that CT has a larger delineation area for tumor volume and has errors. In contrast， MRI and pathological volume are more similar.

[Key words] Cervical cancer; Radiotherapy; Radiation dose; Treatment target area; Imaging technology

宫颈癌（Uterus cervical cancer，UCC）为女性常见性恶性肿瘤，临床上对于该病多采用根治术联合放疗治疗[1]。调强放射可精准选择放射治疗剂量，减轻正常组织的损伤[2]。在宫颈癌治疗中，肿瘤体积会随治疗进程的进展而改变，内靶区运动减弱，影响治疗效果，并损伤正常组织[3-5]。有相关文献指出，放射治疗期间的影像学结果与病理学结果较为相近。因此，可通过对治疗靶区内的影像学特征分析指导放射治疗方案。基于以上背景，本研究全面性剖析宫颈放射治疗的照射剂量变化，并评估MRI、CT与病理肿瘤靶区的相关性。合理勾画治疗靶区，保证治疗的针对性和精准性。突出MRI、CT等影像学图像对于治疗靶区的界定价值，充分发挥影像学技术对于疾病诊治的重要性。为进一步对宫颈癌放射治疗靶区影像学与病理学相关性进行分析，笔者对2019年1月至2020年1月我院收治的61例宫颈癌患者进行研究，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年1月至2020年1月我院收治的61例宫颈癌患者作为研究对象，行放射治疗，年龄39～67岁，平均（50.89±3.72）岁。纳入标准：①对研究知情且完全同意者;②存在放疗治疗适应证者;③Karnofsky评分80分以上[6]者;④经我院医学伦理委员会批准者。排除标准：①心肝肾功能异常者;②曾接受手术或放化疗干预者;③伴有放疗禁忌证[7]者。

1.2方法

对患者采用TP方案化疗治疗，具体方法如下：紫杉醇（江苏恒瑞医药，国药准字H20183378），剂量为135 mg/m2;顺铂（齐鲁制药，国药准字H37021358），剂量为80 mg/m2。……