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目的探讨不同技术和不同体位在直肠癌放疗过程中对小肠受照剂量的影响。方法分别计算67例直肠癌患者采取仰卧位、俯卧位时调强适形放疗(IMRT)、三维适形放疗(3D-CRT)小肠受照体积的平均值并进行比较。结果不同体位计划靶体积(PTV)及小肠体积比较差异无统计学意义(P>0.05),膀胱体积比较差异具有统计学意义(P<0.05)。患者采取相同的治疗体位,不同的放疗方法 ,IMRT比3D-CRT使小肠V20明显降低,差异具有统计学意义(P<0.05),而小肠V10变化不大,差异无统计学意义(P>0.05)。患者接受相同的放疗技术,不同的放疗体位,俯卧位与仰卧位相比,仅有3D-CRT法小肠V10俯卧位较仰卧位降低,差异具有统计学意义(P<0.05),余差异均无统计学意义(P>0.05)。结论不同放疗技术对小肠受照体积影响较大;不同体位对小肠受照体积影响较小。
Objective To investigate the effects of different techniques and different positions on the dose of small intestine during the radiotherapy of rectal cancer. Methods The average volume of IMRT and 3D-CRT in 67 patients with rectal cancer undergoing supine position and prone position were calculated and compared. Results There was no significant difference in target volume (PTV) and small intestine volume between different positions (P> 0.05). The difference of bladder volume was statistically significant (P <0.05). Patients with the same treatment position, different radiotherapy methods, IMRT significantly reduced the V20 of small intestine than 3D-CRT, the difference was statistically significant (P <0.05), while the small intestine V10 little change, the difference was not statistically significant (P> 0.05 ). Compared with the supine position, only the prone position of the V10 of the small intestine of 3D-CRT method was lower than the supine position, the difference was statistically significant (P <0.05), and there was no statistical difference between the two groups Significance (P> 0.05). Conclusion Different radiotherapy techniques have a significant impact on the volume of small intestine; different positions have little effect on the volume of small intestine.