CAJ | 학술논문

目的观察食管癌分次放疗期间靶区变化情况,探讨这些变化对放疗计划实施影响程度.方法选取14例未手术并拟接受全程三维适行放疗食管癌患者.在放疗期间每照射10次重新行定位CT扫描,并且再次勾画靶区(GTV).随后将放疗前制定放疗计划复制到新CT图像上,观察分次放疗期间新勾画靶区与放疗前治疗计划符合程度.结果放疗过程中GTV总体呈递减趋势,14例中5例在照射至第10次时出现CTV增大为初始2.0%～37.7%.95%等剂量曲线包括计划靶体积(PTV)初始计划时为97.81%±1.53%、第10次时为91.95%±5.25%、第20次时为94.27%±4.23%和第30次时为94.03%±6.45%,且在照射后第10、20和30次分别有6、5和4例出现95%等剂量曲线包括PTV降至95%以下.结论食管癌分次放疗期间靶区出现明显变化而使放疗实施存在不确定性.
목적 관찰식관암분차방료기간파구변화정황,탐토저사변화대방료계화실시영향정도.방법 선취14례미수술병의접수전정삼유괄행방료식관암환자.재방료기간매조사10차중신행정위CT소묘,병차재차구화파구(GTV).수후장방료전제정방료계화복제도신CT도상상,관찰분차방료기간신구화파구여방료전치료계화부합정도.결과 방료과정중GTV총체정체감추세,14례중5례재조사지제10차시출현CTV증대위초시2.0%～37.7%.95%등제량곡선포괄계화파체적(PTV)초시계화시위97.81%±1.53%、제10차시위91.95%±5.25%、제20차시위94.27%±4.23%화제30차시위94.03%±6.45%,차재조사후제10、20화30차분별유6、5화4례출현95%등제량곡선포괄PTV강지95%이하.결론 식관암분차방료기간파구출현명현변화이사방료실시존재불학정성.
Objective To investigate the changes of target during fractionated radiotherapy for e-sophageal cancer, and to assess their impact on the implementation of radiotherapy. Methods Fourteen pa-tients with unresectable esophageal cancer were enrolled to receive full course conformal radiotherapy. CT scans were performed after every ten fractions. New targets (GTV) were delineated on repeated CT scans. Then the pretreatment radiotherapy plans were copied to the new targets to investigate the conformity between the new GTV and the plans. Results The majority of the GTVs decreased with the increasing fractions dur-ing radiotherapy. However, GTVs of 35.7% (5/14) patients increased by 2.0%-37.7% at the tenth frac-tion. The PTVs covered by 95% isodose curve at the time of pretreatment,tenth fraction,twentieth fraction and thirtieth fraction were 97.81%±1.53%, 91.95%±5.25%, 94.27%±4.23% and 94.03%±6.45%, respectively. Moreover, at tenth, twentieth and thirtieth fraction, there were 6,5, and 4 patients whose PTVs covered by 95% isodose curve were below 95%, respectively. Conclusions There are signifi-cant target changes during fractionated radiotherapy for esophageal cancer, which may result in uncertainties of radiotherapy implementation.