目的: 分析宫颈癌调强放射治疗中膀胱的不同充盈程度对治疗靶区位置动度的影响。方法: 通过
10 例宫颈癌病人治疗时在线的锥形束CT 扫描，获取每次病人治疗时膀胱体积。同时测量宫颈及宫底参考点相
对于骨性标志的相对位置变化。运用统计方法获得每位病人参考点的相对移动的均值和方差。结果: 无论宫颈
还是宫底随着憋尿程度的不同，造成的膀胱体积的变化，都会引起相对骨性标志的相对位移。其中头脚方向的
变化最大，均值5mm 左右。胸前背后与左右方向变化相对较小，均值3mm 左右。结论: 了解本中心宫颈癌放射
治疗病人膀胱不同充盈程度对治疗靶区动度的影响，通过准确控制临床靶区到治疗靶区的外放范围，为临床上
综合考虑临床靶区( CTV) 到计划靶区( PTV) 的外放距离提供依据。

Objective: To analyze the effect of different filling degree of bladder in the treatment of
cervical cancer with IMRT on the target location．Methods: In 10 cases of cervical cancer patients treated
with an online cone beam CT scanning，access to the bladder volume of each patient’s treatment．At
the same time， the relative position of the cervical and cervical reference points with respect to the bony
landmarks were also measured．Statistical methods were used to obtain the mean and variance of the relative
movement of each patient’s reference point．Results: Regardless of the cervical or fundus with different
degree of holding back urine，caused by the bladder volume changes will cause relative displacement
relative bony landmarks．One of the biggest change in the direction of the head， the mean 5 mm．
Chest behind and left right direction change is relatively small，about 3 mm．Conclusion: Understanding
the radiotherapy of cervical cancer patients with bladder with different degrees of filling for the
treatment target moving effect， through the accurate control of the clinical target volume to the treatment
of target area outside the range， for clinical comprehensive consideration of the clinical target volume
( CTV) to the planning target volume( PTV) distance provides the basis．

R711．74

 收稿日期: 2016－04－21; 修回日期: 2016－08－23
基金项目: 国家自然科学基金地区科学基金( 81660342)
作者简介: 乌晓礼( 1972－) ，男，内蒙古医科大学附属医院放疗科物理师，理学硕士。
通讯作者: 郁志龙，主任医师，E－mail: richrd_yu1961269@ sina．com 内蒙古医科大学附属医院， 010050