CAJ | 학술논문

目的：评价四维CT（4D-CT）与主动呼吸控制技术（ABC）在肺部放疗呼吸管理中的异同，探讨不同患者采用不同呼吸控制技术的适应证和可行性。方法选取21例肺部肿瘤放疗患者进行呼吸运动管理，其中11例患者采用4D-C T 技术，10例患者采用ABC技术。分别计算计划靶区体积（PGTV）与静态大体肿瘤体积（GTV）的比值（PGTV/GTV），比较两种呼吸管理技术在照射靶区、定位时间、计划时间、治疗时间上的差异，探讨不同患者采用不同呼吸控制技术的适应证。结果4D-C T 技术中PGTV/GTV比值为4．38±2．95，ABC技术中PGTV/GTV比值为2．21±0．69，二者比较差异有统计学意义（P＜0．05）；定位时间、照射时间4D-C T技术显著短于ABC技术（ P＜0．05），而计划时间比较差异无统计学意义（ P＞0．05）。使用ABC技术和4D-C T技术的患者客观缓解率分别为50．0％、45．5％，放射性肺炎发生率分别为30．0％、27．3％，二者比较差异无统计学意义（ P＞0．05）。结论肺部放疗中，ABC技术照射体积小，适合体力状况较好患者；4D-CT技术省时、耐受性好，适合肿瘤体积较小患者。
목적：평개사유CT（4D-CT）여주동호흡공제기술（ABC）재폐부방료호흡관리중적이동，탐토불동환자채용불동호흡공제기술적괄응증화가행성。방법선취21례폐부종류방료환자진행호흡운동관리，기중11례환자채용4D-C T 기술，10례환자채용ABC기술。분별계산계화파구체적（PGTV）여정태대체종류체적（GTV）적비치（PGTV/GTV），비교량충호흡관리기술재조사파구、정위시간、계화시간、치료시간상적차이，탐토불동환자채용불동호흡공제기술적괄응증。결과4D-C T 기술중PGTV/GTV비치위4．38±2．95，ABC기술중PGTV/GTV비치위2．21±0．69，이자비교차이유통계학의의（P＜0．05）；정위시간、조사시간4D-C T기술현저단우ABC기술（ P＜0．05），이계화시간비교차이무통계학의의（ P＞0．05）。사용ABC기술화4D-C T기술적환자객관완해솔분별위50．0％、45．5％，방사성폐염발생솔분별위30．0％、27．3％，이자비교차이무통계학의의（ P＞0．05）。결론폐부방료중，ABC기술조사체적소，괄합체력상황교호환자；4D-CT기술성시、내수성호，괄합종류체적교소환자。
Objective To evaluate the similarities and differences between four-dimensional radiotherapy (4D-CT ) and active breathing control techniques(ABC) in respiratory management in lung radiotherapy ,and investigate the indications and feasibility of different breathing control techniques for different patients .Methods Twenty-one patients treated with lung radiotherapy received respiratory management .4D-CT technology was used in 11 patients ,while ABC technology was adopted in the rest 10 .The ratios of planning target volume(PGTV) to gross tumor volume(GTV)[(PGTV/GTV)] were calculated .The differences between these two respiratory management technologies were compared in terms of the PGTV ,positioning time ,planning time and treatment time to investigate the indications .Results 4D-CT technology had higher PGTV/GTV ratio ,and shorter positioning time and irradiation time than ABC technology(P<0 .05) ,but there was no significant difference in the planning time(P>0 .05) .In patients with ABC and 4D-CT technology ,objective response rates were 50 .0% ,45 .5% ,respectively ,and the radiation pneumonitis rates were 30 .0% ,27 .3% ,respectively .There was no significant difference in both groups (P>0 .05) .Conclusion In lung tumor radiothera-py ,ABC can reduce irradiation volume ,suitable for patients with good performance status .4D-CT is time-saving and well tolerated , suitable for patients with smaller tumors .