中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2015年
10期
751-755
,共5页
李奕彤%王雅棣%张富利%许卫东%姚波%陈点点%路娜
李奕彤%王雅棣%張富利%許衛東%姚波%陳點點%路娜
리혁동%왕아체%장부리%허위동%요파%진점점%로나
宫颈癌%螺旋断层放疗%器官运动%实际剂量
宮頸癌%螺鏇斷層放療%器官運動%實際劑量
궁경암%라선단층방료%기관운동%실제제량
Cervical cancer%Tomotherapy%Interfractional organ motion%Actual dose
目的 通过螺旋断层放疗系统(TOMO)观察宫颈癌治疗过程中,肿瘤及邻近组织器官移动所导致的靶区受照剂量的改变.方法 选取2013年8月至2014年2月于本院行TOMO治疗的5例宫颈癌患者,每次治疗前行兆伏级CT(MVCT)扫描与计划CT图像配准后,重新计算剂量分布并勾画肿瘤及靶区.分析分次治疗间肿瘤与靶区体积、位移与受照剂量之间的关系.结果 5例患者外照射结束时宫颈肿物体积、最大径分别平均下降68.90％、26.91％(t =5.21、8.39,P＜0.05).肿瘤、子宫、临床靶区(CTV)质心左右、前后、头脚方向中位位移分别为-1.43、-7.72、0.02、0.40、-1.24、-6.51、-0.43、-1.68和-0.22 mm.CTV中位V95％为99.40％ (95.96％ ～100％),中位漏照体积为6.94 cm3(0 ～32.30 cm3).结论 官颈癌放疗中,肿瘤变化、位置的移动与生理运动等因素的影响,使靶区实际受照剂量与初始计划存在差异,部分靶区漏照,在图像引导放疗(IGRT)下,漏照体积较少.
目的 通過螺鏇斷層放療繫統(TOMO)觀察宮頸癌治療過程中,腫瘤及鄰近組織器官移動所導緻的靶區受照劑量的改變.方法 選取2013年8月至2014年2月于本院行TOMO治療的5例宮頸癌患者,每次治療前行兆伏級CT(MVCT)掃描與計劃CT圖像配準後,重新計算劑量分佈併勾畫腫瘤及靶區.分析分次治療間腫瘤與靶區體積、位移與受照劑量之間的關繫.結果 5例患者外照射結束時宮頸腫物體積、最大徑分彆平均下降68.90％、26.91％(t =5.21、8.39,P＜0.05).腫瘤、子宮、臨床靶區(CTV)質心左右、前後、頭腳方嚮中位位移分彆為-1.43、-7.72、0.02、0.40、-1.24、-6.51、-0.43、-1.68和-0.22 mm.CTV中位V95％為99.40％ (95.96％ ～100％),中位漏照體積為6.94 cm3(0 ～32.30 cm3).結論 官頸癌放療中,腫瘤變化、位置的移動與生理運動等因素的影響,使靶區實際受照劑量與初始計劃存在差異,部分靶區漏照,在圖像引導放療(IGRT)下,漏照體積較少.
목적 통과라선단층방료계통(TOMO)관찰궁경암치료과정중,종류급린근조직기관이동소도치적파구수조제량적개변.방법 선취2013년8월지2014년2월우본원행TOMO치료적5례궁경암환자,매차치료전행조복급CT(MVCT)소묘여계화CT도상배준후,중신계산제량분포병구화종류급파구.분석분차치료간종류여파구체적、위이여수조제량지간적관계.결과 5례환자외조사결속시궁경종물체적、최대경분별평균하강68.90％、26.91％(t =5.21、8.39,P＜0.05).종류、자궁、림상파구(CTV)질심좌우、전후、두각방향중위위이분별위-1.43、-7.72、0.02、0.40、-1.24、-6.51、-0.43、-1.68화-0.22 mm.CTV중위V95％위99.40％ (95.96％ ～100％),중위루조체적위6.94 cm3(0 ～32.30 cm3).결론 관경암방료중,종류변화、위치적이동여생리운동등인소적영향,사파구실제수조제량여초시계화존재차이,부분파구루조,재도상인도방료(IGRT)하,루조체적교소.
Objective To observe the interfractional variation and actual dose for cervical cancer patients treated with tomotherapy.Methods Five patients who received tomotherapy were chosen from Aug 2013 to Feb 2014.A megavohage computed tomography (MVCT) scan was performed before treatment and then registered with the planning CT images.Dose distributions were recalculated and targets were contoured on the MVCT images.The differences between the actual radiation and planning were analyzed.Results In the patients received external radiotherapy, the decline in cervix volume and maximum diameter was 68.90％ and 26.91％ , respectively (t =5.21, 8.39, P ＜0.05).Cervix, uterus and CTV movement in left-right, anteroposterior, superoinferior were 1.43,-7.72, 0.02,-0.40,-1.24, -6.51,-0.43,-1.68and-0.22mm.The medianCTV V95％ was 99.40％ (95.96％-100％), and missing volume was 6.94 cm3 (0-32.30 cm3).Conclusions During radiotherapy for cervical cancer patients, the volume, position and doses are different between initial plan and actual radiation.Based on image guided radiation therapy (IGRT), missing targets are limited.
