宫颈癌调强放疗骨盆不同部位高低剂量区照射体积与全身血液学毒性的关系分析

doi:10.3969/j.issn.1006-6233.2025.08.013

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摘要目的:分析宫颈癌调强放疗(IMRT)骨盆不同部位高低剂量区照射体积与全身血液学毒性的关系。方法:选取2021年4月至2024年4月期间于本院进行IMRT的184例宫颈癌患者为研究对象,所有患者均进行血液学毒性检查,通过单因素分析、二元Logistic回归分析及Spearman分析对患者骨盆不同部位高低剂量区照射体积与全身血液学毒性的关系进行分析。结果:患者RTOG分级结果为1~2级(阴性组),126例(68.48%)患者RTOG分级结果为3~4级(阳性组);阴性组与阳性组年龄、FIGO分期、癌症类型及V5、V30、V40受量比较,差异无统计学意义(P>0.05),阴性组与阳性组化疗周期、同步放化疗及V10、V20受量比较,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,化疗周期不为影响患者血液毒性评价结果的独立影响因素(P>0.05),同步放化疗、V10、V20受量是影响患者血液毒性评价结果的独立影响因素(P<0.05);Spearman分析结果显示,髂骨区V10、V20受量与患者血液学毒性分级呈现显著相关性(P<0.05),髂骨区V5、V30、V40受量及底盆腔区、腰骶脊柱区V5、V10、V20、V30、V40受量与患者血液学毒性无显著相关性(P>0.05)。结论:宫颈癌IMRT患者全身血液学毒性风险高,同步放化疗、V10、V20受照剂量是影响宫颈癌IMRT患者血液毒性评价结果的独立影响因素,且髂骨区V10、V20与患者血液学毒性呈现显著相关性。

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	阿依努尔·色义提
	侯友翔
	高洁
	夏依拉·艾合买提

关键词 ：宫颈癌, 调强放疗, 高低剂量区, 血液学毒性

Abstract：Objective: To analyze the relationship between high-dose and low-dose irradiation volume of different parts of the pelvis and systemic hematologic toxicities in patients undergoing intensity modulated radiotherapy (IMRT) for cervical cancer. Methods: From April 2021 to April 2024, 184 patients with cervical cancer who underwent IMRT in the hospital were selected as the research subjects. All patients underwent hematologic toxicity tests. The relationship between high-dose and low-dose irradiation volume of different parts of the pelvis and systemic hematologic toxicities was analyzed. Results: RTOG grading results showed 58 cases of grade 1~2 (negative group) and 126 cases (68.48%) of grade 3~4 (positive group). There was no statistically significant difference in age, FIGO stage, type of cancer, V5, V30, and V40 Gy between the negative group and the positive group (P>0.05). There were statistically significant differences in chemotherapy cycle, concurrent radiochemotherapy, V10, and V20 Gy between the negative group and the positive group (P<0.05). Binary logistic regression analysis results showed that concurrent radiochemotherapy, V10, and V20 Gy were independent factors influencing the evaluation results of hematologic toxicities (P<0.05). Spearman analysis results showed that there was significant correlation between V10 and V20 Gy of the iliac bone and the grade of hematological toxicity. V5, V30 and V40 Gy of the iliac bone, V5, V10, V20, V30 and V40 Gy of the pelvic floor and lumbosacral spine were not significantly correlated with hematologic toxicities (P>0.05). Conclusion: Patients undergoing IMRT for cervical cancer have a high risk of systemic hematologic toxicities. Concurrent radiochemotherapy, V10 and V20 Gy are independent factors influencing the evaluation results of hematologic toxicities in patients undergoing IMRT for cervical cancer. Moreover, V10 and V20 Gy of the iliac bone are significantly correlated with hematologic toxicities.

Key words： Cervical cancer Intensity modulated radiotherapy High-dose and low-dose zones Hematologic toxicity

基金资助:国家自然科学基金资助项目,(编号:81860528);国家自然科学基金资助项目(预算制项目),(编号:82260520)

通讯作者: 侯友翔

引用本文:

阿依努尔·色义提, 侯友翔, 高洁, 夏依拉·艾合买提. 宫颈癌调强放疗骨盆不同部位高低剂量区照射体积与全身血液学毒性的关系分析[J]. 河北医学, 2025, 31(8): 1309-1314.
Aynur Seyiti, HOU Youxiang, GAO Jie, et al. Relationship between High-Dose and Low-Dose Irradiation Volume of Different Parts of the Pelvis and Systemic Hematologic Toxicities in Patients Undergoing Intensity Modulated Radiotherapy for Cervical Cancer. HeBei Med, 2025, 31(8): 1309-1314.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.08.013 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I8/1309

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