中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2011年
1期
46-49
,共4页
裘国勤%祝成龙%杜向慧%陈建祥
裘國勤%祝成龍%杜嚮慧%陳建祥
구국근%축성룡%두향혜%진건상
食管肿瘤%调强放射疗法%同期加量%淋巴结照射%预防性%剂量学
食管腫瘤%調彊放射療法%同期加量%淋巴結照射%預防性%劑量學
식관종류%조강방사요법%동기가량%림파결조사%예방성%제량학
Esophageal neoplasms%Intensity-modulated radiotherapy%Simultaneous integrated boost%Lymphatic irradiation,prophylactic%Dosimetry
目的 探讨颈段食管癌预防性淋巴结照射同期加量调强放疗(SIB-IMRT)的3种计划的优选方案.方法 对6例颈段食管癌在模拟CT扫描图像上勾画靶区[GTV、CTV(包括双侧中下颈部、锁骨上区、上纵隔淋巴引流区),GTV、CTV分别外扩5 mm为PGTV、PTV],设计5、7、9野下3种SIB-IMRT计划.PGTV处方剂量66 Gy分30次,PTV处方剂量60 Gy分30次.对各计划靶区及危及器官受量进行剂量体积直方图参数比较.结果 5、7、9野SIB-IMRT计划PGTV的适形指数(CI)和V66及D95均明显不同,分别为0.56、0.62、0.69(F=6.22,P＜0.01)和88.24%、95.03%、94.91%(F=4.39,P＜0.05)及6539.67、6601.83、6602.00 cGy(F=4.46,P＜0.05);PTV的也明显不同,分别为0.80、0.85、0.87(F=11.29,P＜0.01)和91.64%、94.05%、95.06%(F=4.10,P＜0.05)及5934.00、5987.17、6006.33 cGy(F=4.01,P＜0.05);脊髓最大受量也不同,分别为4707.17、4497.83、4357.00 cGy(F=11.26,P＜0.01).7、9野间上述各参数比较也均相似(P均＞0.05).结论 7野SIB-IMRT计划是颈段食管癌预防性淋巴结照射SIB-IMRT的优选方案.
目的 探討頸段食管癌預防性淋巴結照射同期加量調彊放療(SIB-IMRT)的3種計劃的優選方案.方法 對6例頸段食管癌在模擬CT掃描圖像上勾畫靶區[GTV、CTV(包括雙側中下頸部、鎖骨上區、上縱隔淋巴引流區),GTV、CTV分彆外擴5 mm為PGTV、PTV],設計5、7、9野下3種SIB-IMRT計劃.PGTV處方劑量66 Gy分30次,PTV處方劑量60 Gy分30次.對各計劃靶區及危及器官受量進行劑量體積直方圖參數比較.結果 5、7、9野SIB-IMRT計劃PGTV的適形指數(CI)和V66及D95均明顯不同,分彆為0.56、0.62、0.69(F=6.22,P＜0.01)和88.24%、95.03%、94.91%(F=4.39,P＜0.05)及6539.67、6601.83、6602.00 cGy(F=4.46,P＜0.05);PTV的也明顯不同,分彆為0.80、0.85、0.87(F=11.29,P＜0.01)和91.64%、94.05%、95.06%(F=4.10,P＜0.05)及5934.00、5987.17、6006.33 cGy(F=4.01,P＜0.05);脊髓最大受量也不同,分彆為4707.17、4497.83、4357.00 cGy(F=11.26,P＜0.01).7、9野間上述各參數比較也均相似(P均＞0.05).結論 7野SIB-IMRT計劃是頸段食管癌預防性淋巴結照射SIB-IMRT的優選方案.
목적 탐토경단식관암예방성림파결조사동기가량조강방료(SIB-IMRT)적3충계화적우선방안.방법 대6례경단식관암재모의CT소묘도상상구화파구[GTV、CTV(포괄쌍측중하경부、쇄골상구、상종격림파인류구),GTV、CTV분별외확5 mm위PGTV、PTV],설계5、7、9야하3충SIB-IMRT계화.PGTV처방제량66 Gy분30차,PTV처방제량60 Gy분30차.대각계화파구급위급기관수량진행제량체적직방도삼수비교.결과 5、7、9야SIB-IMRT계화PGTV적괄형지수(CI)화V66급D95균명현불동,분별위0.56、0.62、0.69(F=6.22,P＜0.01)화88.24%、95.03%、94.91%(F=4.39,P＜0.05)급6539.67、6601.83、6602.00 cGy(F=4.46,P＜0.05);PTV적야명현불동,분별위0.80、0.85、0.87(F=11.29,P＜0.01)화91.64%、94.05%、95.06%(F=4.10,P＜0.05)급5934.00、5987.17、6006.33 cGy(F=4.01,P＜0.05);척수최대수량야불동,분별위4707.17、4497.83、4357.00 cGy(F=11.26,P＜0.01).7、9야간상술각삼수비교야균상사(P균＞0.05).결론 7야SIB-IMRT계화시경단식관암예방성림파결조사SIB-IMRT적우선방안.
Objective To evaluate the optimized simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) plans in cervical esophageal carcinoma underwent prophylactic lymphatic irradiation.MethodsSix patients with cervical esophageal carcinoma were studied.The gross tumor volume (GTV) and clinical target volume (CTV) (including bilateral mid-lower neck and supraclavicular lymph drainage regions,upper mediastinal lymph drainage regions) were delineated on sim-CT images,GTV and CTV were uniformly expanded by 5 mm to create PGTV and PTV.Five fields(5F) ,7F and 9F SIB-IMRT plans were designed.The prescribed doses to PGTV and PTV were 66 Gy and 60 Gy in 30 fractions respectively.The parameters of dose-volume histograms in three groups planning were compared.Results The values of conformity index(CI) of PGTV were 0.56,0.62 and 0.69 (F =6.22,P ＜0.01 ),the V66 with 88.24% ,95.03% and 94.91% ( F = 4.39,P ＜ 0.05 ) and D95 with 6539.67,6601.83 and 6602.00 cGy (F=4.46,P ＜0.05) in 5F,7F and 9F SIB-IMRT plans.The values of CI,V66 and D95 of PTV were 0.80,0.85 and 0.87 (F=11.29,P＜0.01),with 91.64%,94.05% and 95.06% (F=4.10,P＜0.05) and with 5934.00,5987.17 and 6006.33 cGy (F =4.01,P ＜0.05).The values of maximal dose of spinal cord were 4707.17,4497.83 and 4357.00 cGy( F = 11.26 ,P ＜0.011 ) in 5F ,7F and 9F SIB-IMRT plans.The values of all dosimetic parameters about PGTV and PTV were same in 7F and 9F SIB-IMRT plans ( all P ＞ 0.05 ).Conclusion 7F-SIB-IMRT plan is best one scheme for cervical esophageal carcinoma underwent prophylactic lymphatic irradiation.
