目的 评价剂量表面积直方图(dose and surface histogram,DSH)对宫颈癌患者放射性膀胱炎(radiation cystitis,RC)的预测价值.方法 筛选2013年5月—2023年5月河北北方学院附属第一医院HIS系统接受图像引导放疗的宫颈癌患者190例,将患者分为试验组(n=100)和对照组(n=90),收集其资料行回顾性研究.分别采用DSH和剂量体积直方图(dose and volume histogram,DVH)评价试验组和对照组患者膀胱剂量分布.以DVH为参考,采用受试者工作特征曲线评价DSH对RC的预测价值.结果 2组基线资料和RC发生率比较差异均无统计学意义(均P＞0.05).DSH同DVH各项评价指标比较差异均有统计学意义(均P＜0.05).S45和V45对Ⅰ、Ⅱ、Ⅲ级RC发生率的预测价值均为低等(均P＜0.05);S50和V50对 Ⅰ、Ⅱ、Ⅲ级RC发生率的预测价值均为中等(均P＜0.05);S55～S57和V55～V57对Ⅰ、Ⅱ、Ⅲ级RC发生率的预测价值均为高等(均P＜0.05).结论 同DVH相比,DSH对宫颈癌IGRT致RC发生率的预测价值同其基本一致,未来有望成为新的放疗计划评价工具.
Predictive value of a new radiotherapy plan evaluation tool for bladder toxicity in cervical cancer
Objective To evaluate the predictive value of a dose-surface histogram(DSH)for radiation cystitis(RC)in patients with cervical cancer.Methods We retrospectively included 190 patients with cervical cancer who underwent im-age-guided radiotherapy(IGRT)from the HIS system of The First Affiliated Hospital of Hebei North University from May 2013 to May 2023.The patients were divided into test group(n=100)and control group(n=90).The dose distribution in the bladder was evaluated by using a DSH for the test group and using a dose-volume histogram(DVH)for the control group.Receiver operating characteristic curves were used to evaluate the predictive value of DSH for RC in comparison with DVH.Results There were no significant differences in baseline data and RC incidence between the two groups(all P＞0.05).All evaluation indicators were significantly different between DSH and DVH(all P＜0.05).The predictive value of SS45 and V45 for the incidence of grade-Ⅰ,-Ⅱ,and-Ⅲ RC was low(all P＜0.05).The predictive value of S50 and V5o for the incidence of grade-Ⅰ,-Ⅱ,and-Ⅲ RC was moderate(all P＜0.05).S55-S57 and V55-V57 showed high value for predicting the incidence of grade-Ⅰ,-Ⅱ,and-Ⅲ RC(all P＜0.05).Conclusion DSH shows basically the same predictive value for the in-cidence of RC caused by IGRT in cervical cancer as DVH,which is expected to become a new tool for evaluating radiother-apy plans.
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