Objective: To evaluate the relationship of dosimetry parameters and efficacy of (125)I seeds implantation for pelvic recurrent cervical cancer (PRCC) after external beam radiotherapy(EBRT) under CT guidance. Methods: A retrospective analysis was made on 30 PRCC patients after EBRT in Peking University Third Hospital with (125)I seeds implantation under CT guidance. Postoperative plans were made to evaluate the dosimetric parameters. Kaplan-Meier method was used to calculate local progression free survival (LPFS) rate and overall survival (OS) rate, and Log-rank test and Cox regression were used for univariate and multivariate analysis. Results: The 1-year and 2-year LPFS rate was 39.4% and 22.5%, respectively. The 1-year and 2-year OS rate was 57.3% and 27.4%, respectively. On postoperative plan, D(90) was (132±47) Gy, D(100) was (51±24) Gy, V(100) was 88%±10%, V(150)was 69%±15%, V(200) was 51%±18%.LPFS time would be longer while D(90) ≥105 Gy or D(100) ≥ 55 Gy or V(100) ≥ 91% (all P<0.05). D(100) was significantly related to LPFS (P<0.05). But these dosimetry parameters got no effect on OS. Conclusions: LPFS time of (125)I seeds implantation for PRCC after EBRT under CT guidance would be longer when D(90)≥105 Gy or D(100)≥ 55 Gy, or V(100)≥ 91%. D(100) is an independent factor related to LPFS.
目的： 探讨CT引导(125)I放射性粒子植入治疗放疗后盆腔复发宫颈癌患者的剂量学因素对疗效的影响。 方法： 回顾性分析北京大学第三医院接受CT引导(125)I放射性粒子植入治疗的30例放疗后盆腔复发宫颈癌患者，中位年龄43.5(30～75)岁。通过术后计划评估剂量学参数。采用Kaplan－Meier法计算局部无进展生存率(LPFS)和总生存率(OS)，并采用Log－rank检验、Cox回归进行单因素和多因素分析。 结果： 1年和2年LPFS率分别为39.4%、22.5%。1年和2年OS率分别为57.3%、27.4%。术后计划，90%、100%大体肿瘤靶区(GTV)接受的剂量(D(90)和D(100))分别为(132±47)和(51±24)Gy。接受100%、150%、200%的处方剂量的靶区体积百分比(V(100)、V(150)和V(200))分别为88%±10%、69%±15%和51%±18%。D(90)≥105 Gy或D(100)≥55 Gy或V(100)≥ 91%，LPFS明显延长(均P<0.05)。D(100)是影响LPFS的独立因素。但剂量学参数对OS均无影响(均P>0.05)。 结论： CT引导下(125)I放射性粒子植入治疗放疗后盆腔复发宫颈癌，当D(90)≥105 Gy或D(100)≥55 Gy或V(100)≥91%时可延长LPFS，D(100)是影响LPFS的独立因素。.
Keywords: Radiotherapy dosage; Tomography, X-ray computed; Uterine cervical neoplasms.