【摘要】 目的:初步探讨卵巢移位术的最佳移位点,为卵巢在宫颈癌盆腔放疗中的防护提供更多的理论依据。方法:在Elekta Xio计划系统中,分别对仿真体模和宫颈癌患者模拟四野均等、四野非均等、前后两野对穿、左右两野对穿等照射,评估各位点的吸收剂量。结果:各位点的吸收剂量随着卵巢移位高度的增加而显著降低(P<0.01),髂嵴上3cm层面各位点的吸收剂量为(2.94±1.12) Gy,略小于3Gy(P>0.05),髂嵴上4.5cm以上层面各位点的吸收剂量为(1.70±0.22) Gy,明显小于3Gy(P<0.01)。并且两个高度层面的侧方位点的剂量均低于后方。结论:对于接受盆腔盒式放疗的宫颈癌患者,建议在允许范围内将卵巢至少移至髂嵴上3～4.5cm层面,并固定于结肠旁沟靠近侧方的区域,以此减少移位卵巢的吸收剂量。更多还原

【Abstract】 Objective: To initially explore the optimal transposed site of ovarian transposition,and provide more theoretical basis for ovarian protection in pelvic radiotherapy for cervical cancer. Methods: In the Elekta Xio treatment planning system,equal four-field irradiation,unequal four-field irradiation and two parallel opposed fields irradiation were simulated for humanoid phantoms and cervical cancer patients. The absorbed dose at each point was assessed. Results: As the height of ovarian movement increased,the dose in each site decreased significantly( P<0.01). The absorbed dose of each point on the layer 3 cm above the iliac crest was( 2.94±1.12) Gy,slightly less than 3 Gy( P>0.05),and the absorbed dose of each point on the layer 4.5 cm above the iliac crest was( 1.70±0.22) Gy which was significantly less than 3 Gy( P<0.01). Simultaneously,the dose in side of the two layers was less than that in the rear of these two layers. Conclusion: For cervical cancer patients undergoing pelvic radiotherapy,it is recommended to transpose the ovary to at least 3-4.5 cm above the iliac crest and fix it to the area near the side of paracolic sillcus,thus reducing the transposed ovarian dose.更多还原