早期宫颈癌术后VMAT与IMRT的临床效果对比及对放疗剂量血清DCLK1 miR-15b水平的影响

doi:10.3969/j.issn.1006-6233.2025.01.028

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Abstract Objective: To investigate the clinical effects of volumetric arc intensity-modulated radiotherapy (VMAT) and fixed-field static intensity-modulated radiotherapy (IMRT) after surgery for early-stage cervical cancer, as well as their effects on radiotherapy dose, serum levels of doublecortin-like kinase 1 (DCLK1), and microRNA-15b (miR-15b). Methods: A total of 130 patients with early-stage cervical cancer who underwent postoperative radiotherapy at Heping Hospital Affiliated to Changzhi Medical College from January 2021 to January 2023 were selected and randomly divided into a VMAT group (n=65) and an IMRT group (n=65) using a random number table method for a prospective study. The VMAT group received VMAT, while the IMRT group received IMRT. The planned implementation efficiency, target radiotherapy dose, exposure dose to organs at risk, serum DCLK1 and miR-15b levels, intestinal and vaginal microecology, adverse reactions, and recurrence rate were compared between the two groups. Results: The number of machine jumps in the VMAT group was fewer than in the IMRT group, and the treatment time was shorter (P<0.05). There were no significant differences in homogeneity index (HI), conformity index (CI), mean dose (Dmean), minimum dose (Dmin), and maximum dose (Dmax) between the two groups (P>0.05). The rectal Dmean, right femoral head Dmean, left femoral head Dmean, small intestine Dmax, bladder Dmean, and pelvic Dmean in the VMAT group were all lower than those in the IMRT group (P<0.05). There were no significant differences in serum DCLK1 and miR-15b levels between the two groups after radiotherapy (P>0.05). After radiotherapy, the intestinal flora richness, intestinal flora diversity index, vaginal flora diversity score, and vaginal flora density score in the VMAT group were higher than those in the IMRT group (P<0.05). The incidence of myelosuppression, radiation enteritis, gastrointestinal reactions, and bacterial vaginitis in the VMAT group was lower than in the IMRT group (P<0.05). There was no significant difference in the recurrence rate between the two groups (P>0.05). Conclusion: The target radiotherapy dose parameters of VMAT are comparable to those of IMRT. However, VMAT can reduce the number of machine jumps and treatment time, decrease the dose to surrounding organs, improve the intestinal and vaginal microecology, reduce the risk of adverse reactions, and not increase the recurrence rate.

Key words： Cervical cancer Volumetric arc intensity modulated radiotherapy Fixed field static intensity modulated radiotherapy Bifocorticoid kinase 1 Vaginal microecology

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.01.028 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I1/150

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