中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
21期
1353-1357
,共5页
杨柳婷%陈龙%黄江琼%付庆国
楊柳婷%陳龍%黃江瓊%付慶國
양류정%진룡%황강경%부경국
非小细胞肺癌%图像引导%自适应放疗%剂量学
非小細胞肺癌%圖像引導%自適應放療%劑量學
비소세포폐암%도상인도%자괄응방료%제량학
non-small cell lung cancer%image-guided%adaptive radiation%dosimetry
目的:探索非小细胞肺癌实施自适应放疗后危及器官(肺、心脏、脊髓)受照剂量的变化,及危及器官受照剂量降低后靶区处方剂量的变化。方法:12例局部晚期非小细胞肺癌患者在放疗过程中均行两次定位CT扫描,以实行自适应放疗。通过MIM软件,将两次计划进行融合。比较实行自适应放疗后,保证靶区剂量不变的情况下,危及器官的受量有无降低;以及在保证正常组织器官受照剂量与原计划相似的情况下靶区剂量提升的空间。结果:自适应放疗后,在保证靶区受照剂量不变的情况下,肺部V20平均降低3.53%,V30降低2.55%,而全肺平均受照剂量降低2.11 Gy;心脏V30平均降低4.19%、V40降低3.72%;脊髓最大受量平均降低3.52 Gy。危及器官受量与不行自适应放疗时相似的情况下,靶区(PGTV)照射剂量平均提高1.25 Gy。结论:非小细胞肺癌放疗过程中,适时行自适应放疗能够减少周围危及器官的受照剂量,提高靶区(PGTV)的处方剂量。
目的:探索非小細胞肺癌實施自適應放療後危及器官(肺、心髒、脊髓)受照劑量的變化,及危及器官受照劑量降低後靶區處方劑量的變化。方法:12例跼部晚期非小細胞肺癌患者在放療過程中均行兩次定位CT掃描,以實行自適應放療。通過MIM軟件,將兩次計劃進行融閤。比較實行自適應放療後,保證靶區劑量不變的情況下,危及器官的受量有無降低;以及在保證正常組織器官受照劑量與原計劃相似的情況下靶區劑量提升的空間。結果:自適應放療後,在保證靶區受照劑量不變的情況下,肺部V20平均降低3.53%,V30降低2.55%,而全肺平均受照劑量降低2.11 Gy;心髒V30平均降低4.19%、V40降低3.72%;脊髓最大受量平均降低3.52 Gy。危及器官受量與不行自適應放療時相似的情況下,靶區(PGTV)照射劑量平均提高1.25 Gy。結論:非小細胞肺癌放療過程中,適時行自適應放療能夠減少週圍危及器官的受照劑量,提高靶區(PGTV)的處方劑量。
목적:탐색비소세포폐암실시자괄응방료후위급기관(폐、심장、척수)수조제량적변화,급위급기관수조제량강저후파구처방제량적변화。방법:12례국부만기비소세포폐암환자재방료과정중균행량차정위CT소묘,이실행자괄응방료。통과MIM연건,장량차계화진행융합。비교실행자괄응방료후,보증파구제량불변적정황하,위급기관적수량유무강저;이급재보증정상조직기관수조제량여원계화상사적정황하파구제량제승적공간。결과:자괄응방료후,재보증파구수조제량불변적정황하,폐부V20평균강저3.53%,V30강저2.55%,이전폐평균수조제량강저2.11 Gy;심장V30평균강저4.19%、V40강저3.72%;척수최대수량평균강저3.52 Gy。위급기관수량여불행자괄응방료시상사적정황하,파구(PGTV)조사제량평균제고1.25 Gy。결론:비소세포폐암방료과정중,괄시행자괄응방료능구감소주위위급기관적수조제량,제고파구(PGTV)적처방제량。
Objective: To evaluate the potential dose influence to organs at risk (OARs) and targets of adaptive radiotherapy (ART) for non-small cell lung cancer (NSCLC). Methods:Twice positional CT images of 12 patients with locally advanced NSCLC were captured during radio-(n=3) or radio-chemotherapy (n=9) for ART simulation. The twice positional scanningplan was fused using MIM software. The variation of irradiation doses for the lung, heart, and spinal cord was evaluated, and the prescription doses for the targets were escalated. Results:Adaptive radiation enabled dose reduction by an average of 3.53%for lung V20 and by 2.55%for V30. The mean dose for the lung decreased by 2.11 Gy. The dose was reduced by an average of 4.17%for heart V30 and by 3.37%for V40. Meanwhile, the maximum dose for the spinal cord was reduced by 3.52 Gy on average. Lung sparing with ART enabled an iso-mean lung dose escalation of the Planning gross tumor target volume dose, which improved by an average of 1.25 Gy. Conclusion:The adap-tation of radiotherapy for continuous tumor shrinkage during the treatment course for NSCLC reduces doses to OARs, enables signifi-cant dose escalation, and has the potential to increase local control.