图像引导自适应放疗在宫颈癌治疗中的应用

发布时间：2018-05-20 14:54

本文选题：宫颈癌 + 放射治疗　；参考：《山东医药》2015年27期

【摘要】：目的观察图像引导自适应放疗(IGART)在宫颈癌治疗中的应用效果。方法接受放疗的宫颈癌患者14例,借助4D CT扫描图像设计放疗计划及剂量,放疗过程中采用锥形束CT(CBCT)扫描,获取用于IGART的图像。放疗前采用CBCT进行位置验证扫描,并将获取的CBCT图像与计划CT图像进行3D-3D配准,测量患者的摆位误差。借助CBCT图像勾画放疗过程中的肿瘤靶区(PTV),评价计划靶区(PTV)对GTV的覆盖情况。结果 14例患者共执行131次CT扫描,其中治疗前扫描95次,在线匹配后验证扫描36次。在治疗前95次扫描中,患者头脚、前后和左右方向的摆位误差分别为(0.38±0.07)、(0.30±0.09)、(0.28±0.10)cm。36次验证扫描后,患者头脚、前后和左右方向的摆位误差均减少(P均0.05)。患者分次放疗期间,CBCT图像与计划CT图像匹配修正前GTV溢出PTV 6次,未覆盖率为6.3%(6/95),匹配修正后分别为2次和2.1%。结论 IGART用于宫颈癌治疗可减少并修正患者的摆位误差,降低肿瘤靶区脱靶的发生率,缩小临床靶区的外扩边界。
[Abstract]:Objective to observe the effect of image-guided adaptive radiotherapy (IGART) in the treatment of cervical cancer. Methods Fourteen patients with cervical cancer received radiotherapy were treated with 4D CT scan. The radiation plan and dose were designed by 4D CT scan. The IGART images were obtained by cone-beam CTB CT scanning during radiotherapy. CBCT was used for position verification scanning before radiotherapy and 3D-3D registration was performed between the acquired CBCT images and the planned CT images to measure the positioning errors of the patients. CBCT images were used to describe the GTV coverage of tumor targets during radiotherapy. Results A total of 131 CT scans were performed in 14 patients, of which 95 were scanned before treatment and 36 were verified after online matching. In 95 scans before treatment, the errors of head and foot, front and right, and left and right directions were 0. 38 卤0. 07 and 0. 28 卤0. 28 卤0. 28 卤0.10)cm.36, respectively, and the errors of head and foot, front and right, left and right directions were all decreased by 0. 05% (P < 0. 05) after 0. 28 卤0. 28 卤0. 28 卤0. 28 卤0. 28 卤0. 28 卤0. 28 卤0. 28%. There were 6 times of GTV spillover PTV before matching with planned CT images, 6 times without coverage and 2 times and 2.1 times after matching and correction, respectively. Conclusion IGART for cervical cancer treatment can reduce and correct the positioning error, reduce the incidence of tumor target miss, and reduce the expanding boundary of clinical target area.
【作者单位】：汕头大学医学院附属肿瘤医院;
【分类号】：R737.33

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