中国癌症防治杂志
中國癌癥防治雜誌
중국암증방치잡지
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
2013年
3期
231-234,235
,共5页
苏胜发%卢冰%马筑%肖跃华%欧阳伟炜%李青松%胡银祥%栗蕙芹
囌勝髮%盧冰%馬築%肖躍華%歐暘偉煒%李青鬆%鬍銀祥%慄蕙芹
소성발%로빙%마축%초약화%구양위위%리청송%호은상%률혜근
肺肿瘤%非小细胞肺癌%调强放疗%肿瘤体积%变化
肺腫瘤%非小細胞肺癌%調彊放療%腫瘤體積%變化
폐종류%비소세포폐암%조강방료%종류체적%변화
Lung neoplasms%Non-small cell lung cancer%Intensity-modulated radiotherapy%Tumor volume%Change
目的:分析非小细胞肺癌(non-small cell lung cancer,NSCLC)调强放疗(intensity modulated radiotherapy,IMRT)过程中肿瘤体积动态变化的情况。方法25例经病理学或细胞学检查诊断为NSCLC的患者接受IMRT,分别于放疗前、放疗20 Gy、30 Gy、40 Gy、50.5 Gy、61 Gy时予以螺旋CT模拟定位扫描检查,在各次CT扫描上勾画原发肿瘤(GTV)和纵隔转移淋巴结(GTVnd),并分析其变化规律。结果随放疗剂量的增加,GTV和GTVnd的体积逐渐缩小,放疗40 Gy后肿瘤缩小的速度逐渐缓慢,选择放疗40 Gy时肿瘤体积与放疗前肿瘤体积进行比较,GTV(t=5.019, P=0.000)和GTVnd(t=5.267, P=0.000)体积缩小的差异有统计学意义。以中位值为分界点,GTV≥101.45 cm3、GTV<101.45 cm3、GTVnd≥50.35 cm3和GTVnd<50.35 cm3放疗40 Gy后肿瘤体积缩小的速度逐渐缓慢,与放疗前肿瘤体积缩小比较差异均有统计学意义(t=6.019,P=0.000;t=6.491,P=0.000;t=5.449,P=0.000;t=7.919,P=0.000)。大体积肿瘤缩小更快、更明显。结论随着放疗剂量的增加,肿瘤体积逐渐缩小,放疗40 Gy后肿瘤体积缩小的速度逐渐缓慢,大体积肿瘤比小体积肿瘤缩小更快、更明显。
目的:分析非小細胞肺癌(non-small cell lung cancer,NSCLC)調彊放療(intensity modulated radiotherapy,IMRT)過程中腫瘤體積動態變化的情況。方法25例經病理學或細胞學檢查診斷為NSCLC的患者接受IMRT,分彆于放療前、放療20 Gy、30 Gy、40 Gy、50.5 Gy、61 Gy時予以螺鏇CT模擬定位掃描檢查,在各次CT掃描上勾畫原髮腫瘤(GTV)和縱隔轉移淋巴結(GTVnd),併分析其變化規律。結果隨放療劑量的增加,GTV和GTVnd的體積逐漸縮小,放療40 Gy後腫瘤縮小的速度逐漸緩慢,選擇放療40 Gy時腫瘤體積與放療前腫瘤體積進行比較,GTV(t=5.019, P=0.000)和GTVnd(t=5.267, P=0.000)體積縮小的差異有統計學意義。以中位值為分界點,GTV≥101.45 cm3、GTV<101.45 cm3、GTVnd≥50.35 cm3和GTVnd<50.35 cm3放療40 Gy後腫瘤體積縮小的速度逐漸緩慢,與放療前腫瘤體積縮小比較差異均有統計學意義(t=6.019,P=0.000;t=6.491,P=0.000;t=5.449,P=0.000;t=7.919,P=0.000)。大體積腫瘤縮小更快、更明顯。結論隨著放療劑量的增加,腫瘤體積逐漸縮小,放療40 Gy後腫瘤體積縮小的速度逐漸緩慢,大體積腫瘤比小體積腫瘤縮小更快、更明顯。
목적:분석비소세포폐암(non-small cell lung cancer,NSCLC)조강방료(intensity modulated radiotherapy,IMRT)과정중종류체적동태변화적정황。방법25례경병이학혹세포학검사진단위NSCLC적환자접수IMRT,분별우방료전、방료20 Gy、30 Gy、40 Gy、50.5 Gy、61 Gy시여이라선CT모의정위소묘검사,재각차CT소묘상구화원발종류(GTV)화종격전이림파결(GTVnd),병분석기변화규률。결과수방료제량적증가,GTV화GTVnd적체적축점축소,방료40 Gy후종류축소적속도축점완만,선택방료40 Gy시종류체적여방료전종류체적진행비교,GTV(t=5.019, P=0.000)화GTVnd(t=5.267, P=0.000)체적축소적차이유통계학의의。이중위치위분계점,GTV≥101.45 cm3、GTV<101.45 cm3、GTVnd≥50.35 cm3화GTVnd<50.35 cm3방료40 Gy후종류체적축소적속도축점완만,여방료전종류체적축소비교차이균유통계학의의(t=6.019,P=0.000;t=6.491,P=0.000;t=5.449,P=0.000;t=7.919,P=0.000)。대체적종류축소경쾌、경명현。결론수착방료제량적증가,종류체적축점축소,방료40 Gy후종류체적축소적속도축점완만,대체적종류비소체적종류축소경쾌、경명현。
Objective To analyze changes in target tumor volume during intensity-modulated radiotherapy(IMRT)for non-small cell lung cancer(NSCLC). Methods A total of 25 NSCLC patients underwent IMRT.With the following dose series(Gy):20,30,40,50.5 and 61,simulation computed tomography scans were carried out before each treatment to measure changes in gross tumor volume (GTV)and gross target volume of mediastinal nodes (GTVnd). Results Both GTV and GTVnd decreased over the course of IMRT. The lowest dose causing significant changes from baseline was 40 Gy:GTV,t=5.019,P=0.000;GTVnd,t=5.267,P=0.000.IMRT was associated with significant decreases in GTV and GTVnd even after patients were grouped according to initial tumor volumes:GTV≥101.45 ml,t=6.019,P=0.000;GTV<101.45 ml,t=6.491,P=0.000;GTVnd≥50.35 ml,t=5.449,P=0.000;GTVnd<50.35 ml, t=7.919,P=0.000.However,volume changes were greater for larger tumors than for smaller ones. Conclusions GTV and GTVnd grad-ually decreased over the course of IMRT,with larger tumors showing greater decreases. Significant decreases in GTV and GTVnd oc-curred even after treatment at 40 Gy.