中国临床新医学
中國臨床新醫學
중국림상신의학
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
2014年
10期
905-909
,共5页
陆合明%冯国生%陈甲信%舒留洋%蒋海兰%庞强%程金建%彭露杏%吴丹玲%廖超龙%莫颖
陸閤明%馮國生%陳甲信%舒留洋%蔣海蘭%龐彊%程金建%彭露杏%吳丹玲%廖超龍%莫穎
륙합명%풍국생%진갑신%서류양%장해란%방강%정금건%팽로행%오단령%료초룡%막영
鼻咽癌%调强放疗%锥形束CT%图像引导放疗%摆位误差
鼻嚥癌%調彊放療%錐形束CT%圖像引導放療%襬位誤差
비인암%조강방료%추형속CT%도상인도방료%파위오차
Nasopharyngeal carcinoma%Intensity-modulated radiation therapy%Cone-beam computed tomography%Imaged guided radiation therapy%Setup error
目的:利用锥形束计算机断层扫描(CBCT)作为图像引导,评估鼻咽癌调强放疗中分次间和分次内误差并估算计划靶体积( PTV)合适的边界。方法选取接受根治性调强放疗的10例患者进行研究,每次放疗前后对患者进行CBCT。治疗前发现有摆位误差立即在线校正。分别对分次间和分次内左右、上下和前后方向的误差进行记录和分析。结果>2 mm分次间误差在左右、上下和前后方向分别为21.7%、12.7%和34.1%。 CBCT引导下的在线校正可使100%的残留误差在左右和上下方向≤2 mm,使95.5%的残留误差在前后方向的残留误差≤2 mm。三个方向没有>3 mm的残留误差出现。与分次间的误差相比机器旋转位移引起的残留误差显著减少。没有进行每日CBCT扫描,左右、上下和前后方向上外扩的边界分别为4.9 mm、4.0 mm和6.3 mm,每日进行CBCT扫描使各个方向的外扩边界降低到1.2 mm。结论每天CBCT引导是提高鼻咽癌调强放射治疗准确性的有效方式。 CBCT引导下的在线校正可使各方向的外扩边界减少70%~81%。
目的:利用錐形束計算機斷層掃描(CBCT)作為圖像引導,評估鼻嚥癌調彊放療中分次間和分次內誤差併估算計劃靶體積( PTV)閤適的邊界。方法選取接受根治性調彊放療的10例患者進行研究,每次放療前後對患者進行CBCT。治療前髮現有襬位誤差立即在線校正。分彆對分次間和分次內左右、上下和前後方嚮的誤差進行記錄和分析。結果>2 mm分次間誤差在左右、上下和前後方嚮分彆為21.7%、12.7%和34.1%。 CBCT引導下的在線校正可使100%的殘留誤差在左右和上下方嚮≤2 mm,使95.5%的殘留誤差在前後方嚮的殘留誤差≤2 mm。三箇方嚮沒有>3 mm的殘留誤差齣現。與分次間的誤差相比機器鏇轉位移引起的殘留誤差顯著減少。沒有進行每日CBCT掃描,左右、上下和前後方嚮上外擴的邊界分彆為4.9 mm、4.0 mm和6.3 mm,每日進行CBCT掃描使各箇方嚮的外擴邊界降低到1.2 mm。結論每天CBCT引導是提高鼻嚥癌調彊放射治療準確性的有效方式。 CBCT引導下的在線校正可使各方嚮的外擴邊界減少70%~81%。
목적:이용추형속계산궤단층소묘(CBCT)작위도상인도,평고비인암조강방료중분차간화분차내오차병고산계화파체적( PTV)합괄적변계。방법선취접수근치성조강방료적10례환자진행연구,매차방료전후대환자진행CBCT。치료전발현유파위오차립즉재선교정。분별대분차간화분차내좌우、상하화전후방향적오차진행기록화분석。결과>2 mm분차간오차재좌우、상하화전후방향분별위21.7%、12.7%화34.1%。 CBCT인도하적재선교정가사100%적잔류오차재좌우화상하방향≤2 mm,사95.5%적잔류오차재전후방향적잔류오차≤2 mm。삼개방향몰유>3 mm적잔류오차출현。여분차간적오차상비궤기선전위이인기적잔류오차현저감소。몰유진행매일CBCT소묘,좌우、상하화전후방향상외확적변계분별위4.9 mm、4.0 mm화6.3 mm,매일진행CBCT소묘사각개방향적외확변계강저도1.2 mm。결론매천CBCT인도시제고비인암조강방사치료준학성적유효방식。 CBCT인도하적재선교정가사각방향적외확변계감소70%~81%。
Objective To assess interfractional and intrafractional errors and to estimate appropriate margins for planning target volume(PTV) by using daily cone-beam computed tomography(CBCT) guidance in nasopharyngeal carcinoma(NPC) treaded with intensity-modulated readiation therapy(IMRT).Methods Daily pretreatment and post-treatment CBCT scans were acquired separately after initial patient setup and after the completion of each treatment frac-tion in 10 patients treated with IMRT.Online corrections were made before treatment if any translational setup error was found.Interfractional and intrafractional errors were recorded in the right-left(RL), superior-inferior(SI), and anteri-or-posterior( AP) directions.Results For the translational shifts, the interfractional errors >2 mm occurred in 21.7%of measurements in the RL direction, 12.7%in the SI direction, and 34.1%in the AP direction, respectively.Online correction resulted in 100%of residual errors≤2 mm in the RL and SI directions, and 95.5%of residual errors≤2 mm in the AP direction.No residual errors >3 mm occurred in the three directions.For the rotational shifts, significant re-duction was found in the magnitudes of residual errors compared with those of interfractional errors.A margin of 4.9 mm, 4.0 mm, and 6.3 mm was required in the RL, SI, and AP directions, respectively, when daily CBCT scans were not performed.With daily CBCT, the margins were reduced to 1.2 mm in all directions.Conclusion Daily CBCT guid-ance is an effective modality to improve the accuracy of IMRT for NPC.The online correction could result in a 70%~81%reduction in margin size.