Efficacy and Safety Analysis of Different Target Areas Outlined in Adjuvant Radiotherapy for Cervical Cancer Patients with Postoperative Lymphocysts
Objective To investigate the efficacy and safety of different target delineation for lymphatic cysts associated with cervical cancer after operation and adjuvant radiotherapy.Methods A total of 79 patients with lymphocysts and radiotherapy indications after early cervical cancer surgery were selected.All patients were treated with intensity modulated radiotherapy(IM-RT)technology and randomly divided into 2 groups according to the range of clinical target area(CTV).Among them,37 patients in the control group(CTV)delineated the radiotherapy target area according to the guideline specification but did not include lym-phatic cysts,while 42 patients in the observation group(CTV)included lymphatic cysts.The dose volume of radiotherapy for blad-der,small intestine and rectum was evaluated in the 2 groups,and the associated adverse effects were observed.The outcome of lymphatic cyst radiotherapy in the 2 groups was evaluated after radiotherapy.Results There was no statistical difference in the volume of lymphocysts between the 2 groups(P＞0.05).The CTV volume and radiation dose of lymphocysts in the observation group were significantly higher than those in the control group(P＜0.05);DVH showed that there was no statistical difference in the maximum dose DOSEmax of exposed organs(bladder,small intestine and rectum)between the 2 groups(P＞0.05),and V40 of bladder,small intestine and rectum in the observation group was higher than that in the control group(P＜0.05).The inci-dence of radiation cystitis,radiation enteritis and bone marrow suppression in observation group was higher than that in control group,with statistical difference(P＜0.05).After radiotherapy,the total effective rate of the observation group and the control group was 95.24％and 91.89％,respectively,and there was no statistical difference between the 2 groups(P＞0.05).Conclu-sion Radiotherapy can effectively control lymphatic cysts in patients with lymphatic cysts after cervical cancer surgery.Even if part of the lymphatic cysts are covered,the radiation dose is larger and the effective rate is higher.Therefore,there is no need to deliberately cover the lymphatic cysts when drawing the clinical target area,so as to avoid increasing the exposure volume of the o-rgans at risk,thus increasing the side effects.
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