鼻咽癌放疗体积演化研究

发布时间：2018-05-03 09:39

本文选题：放射治疗 + 鼻咽癌　；参考：《苏州大学》2012年硕士论文

【摘要】：放射治疗是肿瘤治疗的三大主要手段之一，精确放疗技术可最大限度保护正常器官与组织及杀灭肿瘤细胞。论文通过鼻咽癌放疗过程中体积变化的临床实验，观测肿瘤体积在放疗进程中的变化，在放射生物学效应基础上建立鼻咽癌放射治疗的体积演化模型，利用所建模型分析鼻咽癌放疗体积变化的临床实验数据；通过模型理论研究和放疗疗效（肿瘤体积退缩）临床实验研究，为优化放疗计划和提高放疗治愈率提供理论和实验依据。项目严格筛选合适的临床患者并且定制个性化的肿瘤治疗方案。不同分期恶性肿瘤患者的肿瘤体积大小各异，形状各异，，放射治疗剂量也有很大不同，而不同年龄的患者预后也不完全一样，所以需要严格选择合适的患者加入实验组，最大限度的减少由个体差异所导致的实验误差。利用CBCT定期行IGRT来获取患者的肿瘤体积。每例患者至少取得四组CBCT图像以供重新勾勒肿瘤靶区，并计算肿瘤体积变化情况。选择合适的采样周期来获取图像，用CBCT替代CT采集患者影像可以使患者受到的剂量减少为5%左右，将对患者的伤害减少到最小，最大化保护患者利益。建立随时间演化的肿瘤体积与照射剂量关系的放疗疗效模型。基于肿瘤自然生长的模型有很多，而结合临床放射治疗的肿瘤生长与抑制模型较少。在Logistic和LQ模型的基础之上，重点考虑再增殖因素，建立了一个放射治疗的肿瘤生长抑制模型。所建模型在一定程度上反映了肿瘤体积在放射治疗过程中随时间和剂量的演化趋势，对于临床肿瘤的治疗和临床方案的评估具有一定的参考意义。恶性肿瘤的成因以及生物学的特性尚未完全被发现，同时在治疗过程中仍存在较多的个体差异及不确定性，进一步研究需要扩大鼻咽癌患者样本和增加影像获取次数，以完善放疗模型。
[Abstract]:Radiotherapy is one of the three main methods of tumor therapy. Accurate radiotherapy can protect normal organs and tissues and kill tumor cells. The volume evolution model of nasopharyngeal carcinoma radiotherapy was established on the basis of radiobiological effects by observing the changes of tumor volume during radiotherapy. The model was used to analyze the clinical experimental data of radiotherapy volume changes in nasopharyngeal carcinoma (NPC), and the model theory and the therapeutic effect of radiotherapy (tumor volume withdrawal) were studied. To optimize the radiotherapy plan and improve the cure rate of radiotherapy to provide theoretical and experimental basis. The program is rigorous in screening suitable clinical patients and customizing personalized cancer therapy. The size and shape of the tumor vary from stage to stage, the dose of radiotherapy is also very different, and the prognosis of patients of different ages is not exactly the same, so it is necessary to strictly select suitable patients to join the experimental group. Minimize the experimental errors caused by individual differences. CBCT was used to measure the tumor volume of the patients with IGRT on a regular basis. Each patient obtained at least four sets of CBCT images for redrawing tumor targets and calculating tumor volume changes. Choosing the appropriate sampling period to obtain the image and using CBCT instead of CT can reduce the dose of the patient to about 5% minimize the injury to the patient and maximize the protection of the benefit of the patient. A model of radiotherapy efficacy was established based on the relationship between tumor volume and irradiation dose over time. There are many models based on the natural growth of tumor, but there are few models of tumor growth and inhibition combined with clinical radiotherapy. On the basis of Logistic and LQ models, a tumor growth inhibition model was established by considering the factors of reproliferation. To some extent, the model reflects the evolution trend of tumor volume with time and dose during radiotherapy, and has a certain reference value for clinical tumor treatment and clinical evaluation. The causes and biological characteristics of malignant tumors have not been fully discovered, and there are still many individual differences and uncertainties in the course of treatment. Further research needs to expand the samples of NPC patients and increase the number of image acquisition. To perfect the model of radiotherapy.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.63

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