CAJ | 학술논문

目的对肺肿瘤利用CBCT图像配准确定PTV外扩距离,与常规调强放疗计划进行比较并行差异评估.方法选10例肺肿瘤患者每周1次肺部CBCT,每次放疗前后分别进行.对数据依据二参数法得到三维方向外扩距离重新勾画靶区制定计划(校正后),并与原计划(校正前)双肺、脊髓的DVH参数、PTV体积和剂量以及NTCP进行比较,差异行协方差分析或Wilcoxson符号秩检验.结果经CBCT校正前后计划的PTV最大剂量、最小剂量、平均剂量,双肺V5、V10、V20、V30、V50均相似(P =0.242 ～0.663),校正后PTV体积、双肺所受平均剂量有优势(P=0.049、0.035),校正后NTCP随V5、V10、V20增加有下降趋势(P=0.146、0.053、0.000).结论利用CBCT技术校正后可缩小PTV体积,减少双肺平均受量,降低NTCP,有可能提高PTV剂量,从而提高肺癌放疗局部控制率.
목적 대폐종류이용CBCT도상배준학정PTV외확거리,여상규조강방료계화진행비교병행차이평고.방법 선10례폐종류환자매주1차폐부CBCT,매차방료전후분별진행.대수거의거이삼수법득도삼유방향외확거리중신구화파구제정계화(교정후),병여원계화(교정전)쌍폐、척수적DVH삼수、PTV체적화제량이급NTCP진행비교,차이행협방차분석혹Wilcoxson부호질검험.결과 경CBCT교정전후계화적PTV최대제량、최소제량、평균제량,쌍폐V5、V10、V20、V30、V50균상사(P =0.242 ～0.663),교정후PTV체적、쌍폐소수평균제량유우세(P=0.049、0.035),교정후NTCP수V5、V10、V20증가유하강추세(P=0.146、0.053、0.000).결론 이용CBCT기술교정후가축소PTV체적,감소쌍폐평균수량,강저NTCP,유가능제고PTV제량,종이제고폐암방료국부공제솔.
Objective To study the CBCT image registration of PTV enlarging distance and IMRT planning(CT-1) for patients with lung cancer,and evaluate their characters.Methods Ten patients with lung cancer were included in the study.Two sets image,before and after radiotherapy,were acquired every week.Then delineated the targeted volume and made the planning (CT-2) according the enlarging distance data.To comparize the parameters of DVH for lung and spinal cord,volumes and dose of PTV and NTCP with CT-1 and CT-2.The difference of two plan was analyzed by covariance analysis or Wilcoxson's z-test.Results The max,min and mean dose of PTV,the lung V5,V10,V20,V30,V50 were similar in both plans (P =0.242-0.663).There was superiority in CT-2 of PTV and lung's mean dose(P =0.049,0,035).The NTCP had the decent tendency followed by the increasing of lung Vs,V10,V20(P =0.146,0.053,0.000).Conclusions CBCT based image registration can reduce PTV,the mean dose of lung,NTCP,and increase PTV dose.This provides a tool for exploring acurate radiotherapy strategies.