中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2011年
6期
506-509
,共4页
徐鹭英%潘建基%王笑良%柏朋刚%李奇欣%费召东%陈传本%马礼钦%唐天兰
徐鷺英%潘建基%王笑良%柏朋剛%李奇訢%費召東%陳傳本%馬禮欽%唐天蘭
서로영%반건기%왕소량%백붕강%리기흔%비소동%진전본%마례흠%당천란
摆位误差%剂量学%头颈部肿瘤/图像引导放射疗法
襬位誤差%劑量學%頭頸部腫瘤/圖像引導放射療法
파위오차%제량학%두경부종류/도상인도방사요법
Set-up error%Dosimetry%Head and neck neoplasms/image guide radiotherapy
目的 通过头颈部肿瘤调强放疗中的平移和旋转摆位误差,分析摆位误差对肿瘤计划靶体积(PTV)及脑干受照剂量的影响,探讨头颈部肿瘤调强放疗中摆位误差在线校正的必要性.方法 30例头颈部肿瘤患者调强放疗中每周1次行治疗机下的锥形束CT扫描(共6次),其图像与计划CT图像融合配准获得x、y、z轴方向平移摆位误差和相应的旋转误差.将上述误差引入治疗计划系统中重新计算得到PTV、脑干等的剂量或体积参数并与原计划的行配对t检验.结果x、y、z轴方向平移摆位误差分别为1.06、0.95、1.31 mm,旋转误差分别为1.04°、1.06°、0.81°.6次摆位误差再计划的PTV 95％体积剂量(D95)和最小剂量明显小于原计划的(6526.6 cGy:6630.3 cGy,t =3.98,P =0.000和5632.6 cGy:5792.5 cGy,t=-2.89,P=0.007).6次摆位误差再计划的脑干接受45 Gy剂量体积(V45)和1％脑干体积剂量(D01)明显大于原计划的(3.54％:2.75％,t =3.84,P=0.001和5129.7 cGy:4919.3 cGy,=4.36,P=0.000).结论 平移和旋转摆位误差导致PTV D95明显不足,脑干V45、脑干D01均明显增加,因此头颈部肿瘤放疗过程中在线误差纠正是必要的.
目的 通過頭頸部腫瘤調彊放療中的平移和鏇轉襬位誤差,分析襬位誤差對腫瘤計劃靶體積(PTV)及腦榦受照劑量的影響,探討頭頸部腫瘤調彊放療中襬位誤差在線校正的必要性.方法 30例頭頸部腫瘤患者調彊放療中每週1次行治療機下的錐形束CT掃描(共6次),其圖像與計劃CT圖像融閤配準穫得x、y、z軸方嚮平移襬位誤差和相應的鏇轉誤差.將上述誤差引入治療計劃繫統中重新計算得到PTV、腦榦等的劑量或體積參數併與原計劃的行配對t檢驗.結果x、y、z軸方嚮平移襬位誤差分彆為1.06、0.95、1.31 mm,鏇轉誤差分彆為1.04°、1.06°、0.81°.6次襬位誤差再計劃的PTV 95％體積劑量(D95)和最小劑量明顯小于原計劃的(6526.6 cGy:6630.3 cGy,t =3.98,P =0.000和5632.6 cGy:5792.5 cGy,t=-2.89,P=0.007).6次襬位誤差再計劃的腦榦接受45 Gy劑量體積(V45)和1％腦榦體積劑量(D01)明顯大于原計劃的(3.54％:2.75％,t =3.84,P=0.001和5129.7 cGy:4919.3 cGy,=4.36,P=0.000).結論 平移和鏇轉襬位誤差導緻PTV D95明顯不足,腦榦V45、腦榦D01均明顯增加,因此頭頸部腫瘤放療過程中在線誤差糾正是必要的.
목적 통과두경부종류조강방료중적평이화선전파위오차,분석파위오차대종류계화파체적(PTV)급뇌간수조제량적영향,탐토두경부종류조강방료중파위오차재선교정적필요성.방법 30례두경부종류환자조강방료중매주1차행치료궤하적추형속CT소묘(공6차),기도상여계화CT도상융합배준획득x、y、z축방향평이파위오차화상응적선전오차.장상술오차인입치료계화계통중중신계산득도PTV、뇌간등적제량혹체적삼수병여원계화적행배대t검험.결과x、y、z축방향평이파위오차분별위1.06、0.95、1.31 mm,선전오차분별위1.04°、1.06°、0.81°.6차파위오차재계화적PTV 95％체적제량(D95)화최소제량명현소우원계화적(6526.6 cGy:6630.3 cGy,t =3.98,P =0.000화5632.6 cGy:5792.5 cGy,t=-2.89,P=0.007).6차파위오차재계화적뇌간접수45 Gy제량체적(V45)화1％뇌간체적제량(D01)명현대우원계화적(3.54％:2.75％,t =3.84,P=0.001화5129.7 cGy:4919.3 cGy,=4.36,P=0.000).결론 평이화선전파위오차도치PTV D95명현불족,뇌간V45、뇌간D01균명현증가,인차두경부종류방료과정중재선오차규정시필요적.
Objective To measure the set-up errors of patients with head and neck (H&N) cancer during the image guided intensity-modulated radiotherapy (IMRT) treatment and analyze the impact of setup errors on dose distribution ; then to further investigate the necessity of adjustment online for H&N cancer during IMRT treatment.Methods Cone-beam CT (CBCT) scanning of thirty patients with H&N cancer were acquired by once weekly with a total of 6 times during IMRT treatment.The CBCT images and the original planning CT images were matched by the bony structure and worked out the translational errors of the x,y,z axis,as well as rotational errors.The dose distributions were recalculated based on the data of each setup error.The dose of planning target volume (PTV) and organs at risk were calculated in the replanning,and than compared with the original plan by paired t-test.Results The mean value of x,y,z axis translational set-up errors were ( 1.06 ± 0.95 ) mm,( 0.95 ± 0.77 ) mm and ( 1.31 ± 1.07 ) mm,respectively.The rotational error of x,y,z axis were ( 1.04 ±0.791 ),( 1.06 ±0.89) and (0.81 ±0.61 ),respectively.PTV 95％ volume dose ( D95 ) and PTV minimal dose of replanning for 6 times set-up were lower than original plan (6526.6 cGy:6630.3 cGy,t =3.98,P =0.000 and 5632.6 cGy:5792.5 cGy,t =- 2.89,P =0.007).Brain stem received 45 Gydose volume ( V45 ) and 1％ brain stem volume dose ( D01 )were higher than original plan ( 3.54％:2.75％,t =3.84,P =0.001 and 5129.7 cGy:4919.3 cGy,t =4.36,P =0.000).Conclusions The set-up errors led to the dose of PTV D95 obviously insufficient and significantly increased V45,D01 of the brainstem.So,adjustment online is necessary for H&N cancer during IMRT treatment.
