九江学院学报(自然科学版)
九江學院學報(自然科學版)
구강학원학보(자연과학판)
JOURNAL OF JIUJIANG UNIVERSITY(NATURAL SCIENCES)
2014年
2期
65-67,74
,共4页
食管癌%三维适形%放射治疗
食管癌%三維適形%放射治療
식관암%삼유괄형%방사치료
esophageal cancer%three-dimensional conformal%radiation therapy
目的:探讨三维适形(3DCRT)放疗治疗食管癌的临床价值。方法对87例食管癌患者,采用深圳一体医疗立体放射定位系统及真空负压袋固定患者,日本东芝16层螺旋CT增强扫描采集患者影像图像,深圳一体医疗立体放射治疗计划系统,一般设5野照射,95%剂量线包括GTV,脊髓在50%剂量线以外, PTV处方剂量, DT50Gy/20F,5f/W。重复CT定位缩野后视患者身体状况和放射反应情况补量DT15-25Gy/5-10F,5F/W。验证:在CT扫描时标出病变上下界结合体中线和椎体前缘为验证参考线,0°和90°(或270°)照射野时观察射野与X、 Y、 Z轴的关系并拍验证片。应用新华XHA600 C型加速器治疗。结果87例患者随访3年以上,1、2、3年生存率分别92%、72%、63%;食管放射反应Ⅰ级87例(100%),Ⅱ级58例(67%),Ⅲ级16例(18%),Ⅳ级未发生;放射性肺炎和放射性脊髓损伤均未发生。结论该方法使用真空垫固定病人稳定可靠治疗重复性好, CT扫描图像勾画靶区病变精确,计划系统治疗剂量准确分布均匀达到三精的目的。在不加重放射性食管反应和全身反应的同时,安全可靠的保护心脏、肺和脊髓的同时可适当提高单次剂量缩短疗程。三维适形放射治疗食管癌是有效的主要治疗方法。
目的:探討三維適形(3DCRT)放療治療食管癌的臨床價值。方法對87例食管癌患者,採用深圳一體醫療立體放射定位繫統及真空負壓袋固定患者,日本東芝16層螺鏇CT增彊掃描採集患者影像圖像,深圳一體醫療立體放射治療計劃繫統,一般設5野照射,95%劑量線包括GTV,脊髓在50%劑量線以外, PTV處方劑量, DT50Gy/20F,5f/W。重複CT定位縮野後視患者身體狀況和放射反應情況補量DT15-25Gy/5-10F,5F/W。驗證:在CT掃描時標齣病變上下界結閤體中線和椎體前緣為驗證參攷線,0°和90°(或270°)照射野時觀察射野與X、 Y、 Z軸的關繫併拍驗證片。應用新華XHA600 C型加速器治療。結果87例患者隨訪3年以上,1、2、3年生存率分彆92%、72%、63%;食管放射反應Ⅰ級87例(100%),Ⅱ級58例(67%),Ⅲ級16例(18%),Ⅳ級未髮生;放射性肺炎和放射性脊髓損傷均未髮生。結論該方法使用真空墊固定病人穩定可靠治療重複性好, CT掃描圖像勾畫靶區病變精確,計劃繫統治療劑量準確分佈均勻達到三精的目的。在不加重放射性食管反應和全身反應的同時,安全可靠的保護心髒、肺和脊髓的同時可適噹提高單次劑量縮短療程。三維適形放射治療食管癌是有效的主要治療方法。
목적:탐토삼유괄형(3DCRT)방료치료식관암적림상개치。방법대87례식관암환자,채용심수일체의료입체방사정위계통급진공부압대고정환자,일본동지16층라선CT증강소묘채집환자영상도상,심수일체의료입체방사치료계화계통,일반설5야조사,95%제량선포괄GTV,척수재50%제량선이외, PTV처방제량, DT50Gy/20F,5f/W。중복CT정위축야후시환자신체상황화방사반응정황보량DT15-25Gy/5-10F,5F/W。험증:재CT소묘시표출병변상하계결합체중선화추체전연위험증삼고선,0°화90°(혹270°)조사야시관찰사야여X、 Y、 Z축적관계병박험증편。응용신화XHA600 C형가속기치료。결과87례환자수방3년이상,1、2、3년생존솔분별92%、72%、63%;식관방사반응Ⅰ급87례(100%),Ⅱ급58례(67%),Ⅲ급16례(18%),Ⅳ급미발생;방사성폐염화방사성척수손상균미발생。결론해방법사용진공점고정병인은정가고치료중복성호, CT소묘도상구화파구병변정학,계화계통치료제량준학분포균균체도삼정적목적。재불가중방사성식관반응화전신반응적동시,안전가고적보호심장、폐화척수적동시가괄당제고단차제량축단료정。삼유괄형방사치료식관암시유효적주요치료방법。
Objective To investigate the clinical value of three -dimensional conformal (3DCRT) radiothera-py treatment of esophageal cancer .Method 87 cases of esophageal cancer were treated with stereotactic radiosurgery , Shenzhen comprehensive medical positioning system and vacuum bag -fixed patients , Toshiba 16-slice spiral CT image capture patient images , Shenzhen comprehensive medical three -dimensional radiation treatment planning system , general-ly located 5 field irradiation, 95%dose line, including GTV, spinal cord at 50% of the dose outside, PTV prescription dose, DT50Gy/20f, 5f /W.Repeat CT localization shrinking field rear -view physical condition of patients and radiation reactions fill volume DT15-25Gy/5-10f, 5f /W.The CT scan marked lesions combination of upper and lower bounds for the verification vertebral midline and the reference line , and zero and 90 degrees (or 270 degrees) were observed when the radiation field and X , Y, Z axis relationships were shot in films for verification .Xinhua type accelerator treatment was applied.Result 87 patients were followed up for more than three years , and 3-year survival rates were 92%, 72%, 63%.Esophagus radio -reaction gradeⅠwere 87 cases ( 100%) , Ⅱ grade 58 cases ( 67%) , Ⅲ Grade 16 cases (18%) andⅣgrade did not occur .Radiation pneumonitis and radioactive spinal cord injury did not occur .Conclusion This method uses the patient is stable and reliable vacuum pad fixed reproducible treatment , CT scan images accurately de-lineate target lesions , the treatment planning system to achieve an accurate dose distribution Sansei purposes .In response without adding radiation esophagitis and systemic reactions , while safe and reliable protection of the heart , lungs and spinal cord, a single dose may be appropriate to increase the shortened course of treatment .Three-dimensional conformal radio-therapy for esophageal carcinoma is effective primary treatment .