中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
3期
263-266
,共4页
杨成梁%X.Allen Li%王建华%李定杰%毛荣虎
楊成樑%X.Allen Li%王建華%李定傑%毛榮虎
양성량%X.Allen Li%왕건화%리정걸%모영호
胰腺肿瘤/放射疗法%放射疗法,图像引导%放射疗法,自适应%分次间位置变化
胰腺腫瘤/放射療法%放射療法,圖像引導%放射療法,自適應%分次間位置變化
이선종류/방사요법%방사요법,도상인도%방사요법,자괄응%분차간위치변화
Pancreatic neoplasms/radiotherapy%Radiotherapy,image-guided%Radiotherapy,adaptive%Inter-fractional position variations
目的 定量描述胰腺癌放疗分次间解剖位置变化及自适应放疗剂量优势.方法 回顾分析图像引导放疗的10例胰腺癌患者的226套治疗当天CT图像,自动勾画软件勾画靶器官和危及器官轮廓后由经验丰富的医师修改.应用质心距离、最大重叠率和Dice系数定量分析分次间器官移位和变形.应用自适应放疗技术处理治疗当天CT图像,比较自适应治疗计划和校位治疗计划的剂量参数.结果 胰腺癌放疗过程中胰头分次间解剖变化显著,经骨性或软组织对齐配准后胰头质心距离、最大重叠率和Dice系数分别为(7.8±1.3)mm、(87.2±8.4)％和(77.2±7.9)％.自适应治疗计划靶体积(PTy)包绕和危及器官保护方面均优于校位治疗计划,自适应治疗计划将校位治疗计划PTV的V100从(93.32 ±2.89)％提高至(96.03±1.42)％(t=2.79,P=0.008),同时将校位治疗计划的十二指肠V50.4从(43.4±12.71)％降至(15.6±6.25)％(t =3.52,P=0.000).结论 自适应放疗能有效应对胰腺癌放疗中分次间的解剖变化,可提高胰腺癌放疗剂量,这为提高胰腺癌局部控制率带来了希望.
目的 定量描述胰腺癌放療分次間解剖位置變化及自適應放療劑量優勢.方法 迴顧分析圖像引導放療的10例胰腺癌患者的226套治療噹天CT圖像,自動勾畫軟件勾畫靶器官和危及器官輪廓後由經驗豐富的醫師脩改.應用質心距離、最大重疊率和Dice繫數定量分析分次間器官移位和變形.應用自適應放療技術處理治療噹天CT圖像,比較自適應治療計劃和校位治療計劃的劑量參數.結果 胰腺癌放療過程中胰頭分次間解剖變化顯著,經骨性或軟組織對齊配準後胰頭質心距離、最大重疊率和Dice繫數分彆為(7.8±1.3)mm、(87.2±8.4)％和(77.2±7.9)％.自適應治療計劃靶體積(PTy)包繞和危及器官保護方麵均優于校位治療計劃,自適應治療計劃將校位治療計劃PTV的V100從(93.32 ±2.89)％提高至(96.03±1.42)％(t=2.79,P=0.008),同時將校位治療計劃的十二指腸V50.4從(43.4±12.71)％降至(15.6±6.25)％(t =3.52,P=0.000).結論 自適應放療能有效應對胰腺癌放療中分次間的解剖變化,可提高胰腺癌放療劑量,這為提高胰腺癌跼部控製率帶來瞭希望.
목적 정량묘술이선암방료분차간해부위치변화급자괄응방료제량우세.방법 회고분석도상인도방료적10례이선암환자적226투치료당천CT도상,자동구화연건구화파기관화위급기관륜곽후유경험봉부적의사수개.응용질심거리、최대중첩솔화Dice계수정량분석분차간기관이위화변형.응용자괄응방료기술처리치료당천CT도상,비교자괄응치료계화화교위치료계화적제량삼수.결과 이선암방료과정중이두분차간해부변화현저,경골성혹연조직대제배준후이두질심거리、최대중첩솔화Dice계수분별위(7.8±1.3)mm、(87.2±8.4)％화(77.2±7.9)％.자괄응치료계화파체적(PTy)포요화위급기관보호방면균우우교위치료계화,자괄응치료계화장교위치료계화PTV적V100종(93.32 ±2.89)％제고지(96.03±1.42)％(t=2.79,P=0.008),동시장교위치료계화적십이지장V50.4종(43.4±12.71)％강지(15.6±6.25)％(t =3.52,P=0.000).결론 자괄응방료능유효응대이선암방료중분차간적해부변화,가제고이선암방료제량,저위제고이선암국부공제솔대래료희망.
Objective To quantitatively characterize the inter-fractional anatomy variations and advantages of dosimetry for the adaptive radiotherapy in pancreatic cancer.Methods A total of 226 daily CT images acquired from 10 patients with pancreatic cancer treated with image-guided radiotherapy were analyzed retrospectively.Targets and organs at risk (OARs) were delineated by the atlas-based automatic segmentation and modified by the skilled physician.Various parameters,including the center of mass (COM) distance,the maximal overlap ratio (MOR) and the Dice coefficient (DC),were used to quantify the inter-fractional organ displacement and deformation.The adaptive radiation therapy (ART) was applied to handle the daily GT images.The dose distributions parameters from the ART plan were compared with those from the repositioning plan.Results The inter-fractional anatomy variations of pancreas head were obvious in the pancreatic cancer irradiation.The mean COM distance,MOR and DC of pancreas head after the bony or soft tissue alignment and registration was ( 7.8 ± 1.3 ) mm,( 87.2 ± 8.4 )％ and ( 77.2 ±7.9)％ respectively.Compared with the repositioning plan,the ART plan had better target coverage and OARs sparing.For example,the mean V100 of PTV was improved from (93.32 ± 2.89) ％ for repositioning plan to ( 96.03 ± 1.42) ％ for ART plan with t =2.79,P =0.008 and the mean V50.4 for duodenum was reduced from (43.4 ± 12.71 )％ for the repositioning plan to (15.6 ± 6.25)％ for the ART plan with t =3.52,P=0.000.Conclusions The ART can effectively account for the obvious inter-fractional anatomy variations in pancreatic cancer irradiation and be used to escalate the radiotherapy dose for the pancreatic cancer,which will lead to a promising higher local control rate.
