中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2014年
3期
220-224
,共5页
沈文斌%高红梅%祝淑钗%李幼梅%曹彦坤%李曙光%苏景伟%刘志坤%李娟
瀋文斌%高紅梅%祝淑釵%李幼梅%曹彥坤%李曙光%囌景偉%劉誌坤%李娟
침문빈%고홍매%축숙차%리유매%조언곤%리서광%소경위%류지곤%리연
食管肿瘤/三维适形放射疗法%累及野照射%淋巴结引流区%剂量学
食管腫瘤/三維適形放射療法%纍及野照射%淋巴結引流區%劑量學
식관종류/삼유괄형방사요법%루급야조사%림파결인류구%제량학
Esophageal neoplasms/three-dimensional conformal radiotherapy%Involve field irradiation%Lymph node drainage area%Dosimetry
目的 分析食管癌三维适形累及野照射时相应淋巴结引流区受照剂量.方法 回顾分析2000-2004年间81例食管癌患者资料,依据病变部位分别勾画相应淋巴结引流区,分析各淋巴结引流区PTV的体积剂量学参数.结果 患者VPTV-n30、VP rv-n35、VPTV-n40、VPTV-n45、VPTV-n50中位数分别为73％、70％、67％、64％、58％.处方剂量大小与VPTV-n30、VPTV-n35无关(P=0.215、0.054),与VPTV-n40～50有关(P =0.027、0.002、0.000);照射野数多少与VPTV-n30～45无关(P=0.438、0.535、0.425、0.313)而与VPTV-n50有关(P=0.045);病变食管钡餐造影X线长度及PTV大小与V PTV-n30～50均有关(所有P＜0.05).单因素方差分析结果显示胸上段的VPTV-nx值均大于胸中段及胸下段,且VPTV-n30～35值的大小因病变部位不同差异有显著性(P=0.028、0.045),而VPTV-n40～50则未见显著性差异(P=0.076、0.173、0.695).VPTV-nx值大小对患者长期生存均无影响(所有P＞0.05).结论 食管癌三维适形累及野照射时相应淋巴结引流区受到一定剂量照射,可能对预防区域淋巴结转移有一定作用,这有待临床研究进一步证实.
目的 分析食管癌三維適形纍及野照射時相應淋巴結引流區受照劑量.方法 迴顧分析2000-2004年間81例食管癌患者資料,依據病變部位分彆勾畫相應淋巴結引流區,分析各淋巴結引流區PTV的體積劑量學參數.結果 患者VPTV-n30、VP rv-n35、VPTV-n40、VPTV-n45、VPTV-n50中位數分彆為73％、70％、67％、64％、58％.處方劑量大小與VPTV-n30、VPTV-n35無關(P=0.215、0.054),與VPTV-n40～50有關(P =0.027、0.002、0.000);照射野數多少與VPTV-n30～45無關(P=0.438、0.535、0.425、0.313)而與VPTV-n50有關(P=0.045);病變食管鋇餐造影X線長度及PTV大小與V PTV-n30～50均有關(所有P＜0.05).單因素方差分析結果顯示胸上段的VPTV-nx值均大于胸中段及胸下段,且VPTV-n30～35值的大小因病變部位不同差異有顯著性(P=0.028、0.045),而VPTV-n40～50則未見顯著性差異(P=0.076、0.173、0.695).VPTV-nx值大小對患者長期生存均無影響(所有P＞0.05).結論 食管癌三維適形纍及野照射時相應淋巴結引流區受到一定劑量照射,可能對預防區域淋巴結轉移有一定作用,這有待臨床研究進一步證實.
목적 분석식관암삼유괄형루급야조사시상응림파결인류구수조제량.방법 회고분석2000-2004년간81례식관암환자자료,의거병변부위분별구화상응림파결인류구,분석각림파결인류구PTV적체적제량학삼수.결과 환자VPTV-n30、VP rv-n35、VPTV-n40、VPTV-n45、VPTV-n50중위수분별위73％、70％、67％、64％、58％.처방제량대소여VPTV-n30、VPTV-n35무관(P=0.215、0.054),여VPTV-n40～50유관(P =0.027、0.002、0.000);조사야수다소여VPTV-n30～45무관(P=0.438、0.535、0.425、0.313)이여VPTV-n50유관(P=0.045);병변식관패찬조영X선장도급PTV대소여V PTV-n30～50균유관(소유P＜0.05).단인소방차분석결과현시흉상단적VPTV-nx치균대우흉중단급흉하단,차VPTV-n30～35치적대소인병변부위불동차이유현저성(P=0.028、0.045),이VPTV-n40～50칙미견현저성차이(P=0.076、0.173、0.695).VPTV-nx치대소대환자장기생존균무영향(소유P＞0.05).결론 식관암삼유괄형루급야조사시상응림파결인류구수도일정제량조사,가능대예방구역림파결전이유일정작용,저유대림상연구진일보증실.
Objective To analyze the doses to lymph node drainage areas during involved-field irradiation (IFI) in three-dimensional conformal radiotherapy (3DCRT) for esophageal cancer (EC).Methods A retrospective analysis was performed on the clinical data of 81 patients with medically inoperable thoracic EC who received IFI from 2000 to 2004.The lymph node drainage areas were delineated based on the lesions,and the dose-volume parameters of the planning target volume (PTV) of each lymph node drainage area was analyzed.Results The median values of V30,V35,V40,V45,and V50 were 73 ％,70％,67％,64％,and 58％,respectively.The prescribed dose was not significantly correlated with V30 and V35 (P =0.215,0.054),but significantly correlated with V40 and V50 (P =0.027,0.002,0.000) ; the number of radiation fields was not significantly correlated with V30 and V45 (P =0.438,0.535,0.425,0.313),but significantly correlated with V50(P =0.045) ;the length of lesion on barium meal examination and volume of PTV were significantly correlated with V30 and V50 (all P ＜ 0.05).The one-way analysis of variance showed that the Vx value of upper-thoracic segment was greater than those of middle-and lowerthoracic segments (P =0.028,0.045) ; the values of V30 and V35 varied significantly between different lesions,but there were no significant differences in the values of V40 and V50 (P =0.076,0.173,0.695).The Vx value had no significant impact on the long-term survival of patients (all P ＞ 0.05).Conclusions The lymph node drainage areas of EC receive a considerable dose with IFI in 3DCRT,which may play a certain role in preventing regional lymph node metastasis,but more clinical studies are needed.
