锥形束CT评价前列腺癌容积调强弧形放射治疗分次间摆位误差及外放边界研究

发布时间：2017-12-27 11:42

本文关键词：锥形束CT评价前列腺癌容积调强弧形放射治疗分次间摆位误差及外放边界研究　出处：《中国全科医学》2016年21期 　论文类型：期刊论文

【摘要】：目的利用锥形束CT(CBCT)评价前列腺癌容积调强弧形放射治疗(VMAT)分次间摆位误差及其分布情况,为临床靶区(CTV)到计划靶区(PTV)所需的外放边界提供依据。方法选取2014年1—10月在温州医科大学附属第一医院放射治疗中心接受根治性放射治疗的前列腺癌患者40例,均采用VMAT,治疗前1 h嘱患者排空膀胱和直肠,然后喝水500 ml,憋尿充盈膀胱,使治疗时和CT定位时的膀胱和直肠充盈程度尽量一致。所有患者首次摆位后行CBCT扫描,得出校正前摆位误差,在线校正后开始VMAT,2 Gy/次,5次/周,共计39次,照射总剂量为78 Gy。结果每例患者CBCT扫描得出16组误差数据,共计640组误差数据。统计学分析得出前列腺癌VMAT分次间摆位误差为:左右方向(0.14±0.10)cm,头脚方向(0.28±0.13)cm,腹背方向(0.18±0.12)cm;利用公式外放边界=2.5Σ+0.7δ计算出前列腺癌VMAT时CTV到PTV的外放边界为:左右方向0.41 cm,头脚方向0.80 cm,腹背方向0.54 cm。结论 CBCT可以在线验证前列腺癌VMAT时分次间的摆位误差,实时校正摆位误差,实现精确放射治疗。
[Abstract]:Objective to evaluate the setup error and distribution of prostate cancer volume modulated arc radiotherapy (VMAT) by cone beam CT (CBCT), and to provide evidence for clinical target area (CTV) to the external boundary of planned target area (PTV). Methods from 2014 1 to October in the radiotherapy center of the First Affiliated Hospital of Wenzhou Medical University, 40 patients with prostate cancer after radical radiotherapy were used before treatment VMAT, 1 h patients were asked to empty the bladder and rectum, and then drink 500 ml, water filling of bladder in the treatment of CT and positioning of the bladder and rectum filling the degree as possible. All patients were placed in the CBCT scan for the first time. The setup error before correction was corrected. After online correction, VMAT was started, 2 Gy/ times, 5 times / week, 39 times, the total dose of radiation was 78 Gy. Results 16 sets of error data were obtained in each case with 16 sets of error data, with a total of 640 sets of error data. Statistical analysis of prostate cancer VMAT intrafractional setup error: direction (0.14 + 0.10) cm, head foot direction (0.28 + 0.13) cm, under the direction of (0.18 + 0.12) cm; using the formula =2.5 sigma delta +0.7 margin is calculated when the CTV prostate cancer VMAT to PTV on the boundary is about the direction of 0.41 cm, 0.80 cm head foot direction, under the direction of 0.54 cm. Conclusion CBCT can verify the swinging error between the VMAT time division of prostate cancer and correct the pendulum error in real time and achieve accurate radiotherapy.
【作者单位】：温州医科大学附属第一医院放化疗科;
【基金】：浙江省自然科学基金资助项目(LY16H160046)
【分类号】：R737.25
【正文快照】： 近年来,我国前列腺癌发病率呈明显上升趋势,前列腺癌成为严重影响我国老年男性健康的恶性肿瘤,放射治疗是治疗晚期局部前列腺癌的重要手段[1]。如何通过改进放射治疗技术来提高前列腺照射剂量,同时不增加周围器官的并发症是前列腺癌治疗的热点[2]。容积调强弧形放射治疗(volum

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