CAJ | 학술논문

收集6例肺癌患者，在放疗过程中每完成10次分次治疗后，重新扫描、设计计划，并将新计划应用于下一阶段治疗。经过3个阶段放疗后，肿瘤体积缩减(65．59±17．09)%。3种计划中肿瘤靶区的剂量差异无统计学意义。自适应放疗计划(ART)与调强放疗(IMRT)相比，全肺V20、V30、肺平均剂量( MLD )分别减少2．01%、2．66%、241．78 cGy( P =0．005、0．039、0．026)；ART2同 ART1相比，全肺V20、V30、MLD 分别减少3．21%、2．97%、288．64 cGy ( P =0．005、0．013、0．046)。患侧肺V20、V30、MLD减少差异有统计学意义(P<0．05)，而健侧肺指标差异无统计学意义。心脏的V50和Dmean、食管的 V55差异无统计学意义。 ART1与IMRT、ART2与 ART1相比，食管的 Dmean平均分别减少261．98 cGy ( P =0．002)、300．43 cGy ( P =0．008)。脊髓的D2%和Dmean也依次降低，差异有统计学意义(P<0．05)。
수집6례폐암환자，재방료과정중매완성10차분차치료후，중신소묘、설계계화，병장신계화응용우하일계단치료。경과3개계단방료후，종류체적축감(65．59±17．09)%。3충계화중종류파구적제량차이무통계학의의。자괄응방료계화(ART)여조강방료(IMRT)상비，전폐V20、V30、폐평균제량( MLD )분별감소2．01%、2．66%、241．78 cGy( P =0．005、0．039、0．026)；ART2동 ART1상비，전폐V20、V30、MLD 분별감소3．21%、2．97%、288．64 cGy ( P =0．005、0．013、0．046)。환측폐V20、V30、MLD감소차이유통계학의의(P<0．05)，이건측폐지표차이무통계학의의。심장적V50화Dmean、식관적 V55차이무통계학의의。 ART1여IMRT、ART2여 ART1상비，식관적 Dmean평균분별감소261．98 cGy ( P =0．002)、300．43 cGy ( P =0．008)。척수적D2%화Dmean야의차강저，차이유통계학의의(P<0．05)。
Six patients with lung cancer treated with therapy were included. They were retrieved the image and re-planned by fraction 10. The volume of GTV was reduced (65. 59 ± 17. 09)% after three-stage treatments. The doses of target tumor were the same in three-stage treatments. Compared with IMRT, ART1 reduced V20 , V30 , MLD of whole lung by 2. 01%,2. 66%,241. 78 cGy(P=0. 005,0. 039,0. 026). Compared with ART1,ART2 further re-duced the indexes by 3. 21%,2. 97%,288. 64 cGy(P=0. 005,0. 013,0. 046). The doses of ipsilateral lung were reduced significantly (P<0. 05). But this was not for opposite lung. The dose V50,Dmean of heart and V55 of esopha-gus were similar to each plan. Dmean of esophagus with ART1 was smaller than with IMRT(261. 98 cGy,P=0. 002) and Dmean of esophagus with ART2 was smaller than with ART1(300. 43 cGy,P=0. 008). D2% and Dmean of spinal cord were reduced in turn significantly(P<0. 05).