The Study On Evaluating Treatment Effects Of Cervicalcarcinoma Three-Dimensional Conformal Radiotherapy By Dual Source CT Perfusion Imaging

Objective: To analyze the clinical effect of three-dimensional conformal radiotherapy in cervical cancer, and to study the value of dual source CT perfusion imaging in cervical cancer radical radiotherapy.Methods: 56 cases of cervical cancer patients treated in the First Hospital of Lanzhou University Radiotherapy department from January 2011 to December 2012 were collected for the study. All patients were implemented by radical radiotherapy plan. The German Siemens dual energy computer tomography was used for cervical tissue before and after radiotherapy, and CT perfusion imaging and blood flow(BF), blood volume(BV), peak enhancement(PEI), mean transit time(MTT) and surface permeability(PS) were observed. To analyze Correlation between the parameters of DSCT perfusion and the effect of radiotherapy for cervical cancer.Results: 1. Clinical observation of three dimensional conformal radiotherapy in cervical cancer radical radiotherapy:In all 56 cases of cervical cancer patients after radiotherapy, 23 cases achieved CR, accounting for 41.0%; PR: 27, accounting for 48.2%; SD: 5, accounting for 8.9%; PD: 1, accounting for 1.8%; treatment efficiency rate was 89.2%, disease control rate was 98.1%. 2. The most common adverse reactions of early treatment were bone marrow suppression, accounting for 26.8%, followed by bladder reactions,19.6%, the vaginal reaction was 17.9%, rectal response was17.9%. Proctitis was the most common delayed adverse reactions, the rate was 8.9%, followed by radiation cystitis, the rate was 5.4%, edema of lower extremity was 5.4%. 3. The survival rate was 92.9% 1 year follow-up, 2 year was 83.9%, 3 year was 71.4%, the more severe stages of cancer patients, the worse of prognosis. 4. After 1 month of treatment, CT image showed the tumor volume reduction, and tumor enhancement obviously, and CT value was higher than that before treatment. Compared with pre-radiotherapy, CT perfusion parameters were significantly higher than after radiotherapy. 5. Analysis CT perfusion parameters of radiotherapy: BF, BV and PS were significant higher than before, P<0.01. MTT and PEI are slightly higher than before radiotherapy, and difference was not significant, P>0.05. 6 months follow-up after radiotherapy, CT perfusion parameters was significantly reduced compared with before radiotherapy, and BF, BV and PEI were significantly lower than before radiotherapy, MTT and PS were higher than before radiotherapy. It showed a significant difference, all P <0.01. 6. The correlation analysis between DSCT perfusion parameters and short-term effect of radiotherapy: There was positive correlation between short-term effect of radiotherapy and the mean values on BV, BF and PS, there was no correlation between short-term effect of radiotherapy on PEI and MTT. 7. The correlation analysis for the DSCT perfusion parameters of effective group before and after radiotherapy: There were significant difference between before radiotherapy and after radiotherapy in BF, BV, PEI、MTT、PS in radiotherapy effective group. 8. The correlation analysis for the DSCT perfusion parameters of ineffective group before and after radiotherapy: In radiotherapy ineffective group there was no significant difference between before radiotherapy and after radiotherapy in BF, BV, PEI、MTT、PS, P> 0.05. 9. BF and PS was independent factor affecting the efficacy of radiotherapy for cervical cancer.Conclusion: 1.Cervical three-dimensional conformal radiotherapy can improve short and long term clinical outcomes and reduce the incidence of adverse reactions after treatment, there is a greater clinical value. 2. The early postoperative adverse reactions of three-dimensional conformal radiotherapy was bone marrow suppression, Delayed adverse reactions was radiation proctitis in common. 3. Dual source CT perfusion imaging and perfusion parameters can evaluate and predict cervical cancer radical effects of radiotherapy, and there is a high clinical. BF and PS was independent factor affecting the efficacy of radiotherapy for cervical cancer, to evaluate the sensitivity of radical radiation therapy of cervical cancer.