鼻咽癌调强放疗中正常器官体积剂量的变化及其临床意义
发布时间：2019-03-28 06:40
【摘要】： 目的:运用重复CT扫描和重新设计计划,观察鼻咽癌患者在调强放疗过程中正常器官体积及剂量的变化。 方法:选择接受全程调强放疗(intensity modulated radiotherapy, IMRT)的首治鼻咽癌(nasopharyngeal carcinoma, NPC)患者20例,鼻咽、颈部和锁骨上区均懫用IMRT技术,按IMRT步骤设计计划1并得到DVH1。患者在放疗20次时,按原固定体位和参考坐标重新CT扫描,拷贝计划1至重新勾画的靶区产生计划1-2和DVH1-2,对第二次CT扫描重新进行设计得到计划2并得到DVH2。应用CT扫描和DVH图对放疗前和放疗20次时正常器官的体积剂量进行比较分析。 结果:与计划1相比较,计划1-2左右腮腺体积明显小于DVH1(P0.05),左右腮腺的最大剂量、平均剂量、D50和V35,脊髓的最大剂量、平均剂量和D1cc均明显增加(P0.05),脑干最大剂量增大(P=0.011),腮腺的剂量增加与放疗所致的体重下降、轮廓减少和腮腺体积缩小程度密切相关性,脊髓的最大剂量增加与左右轮廓减少程度有一定的相关性(r=0.469,p=0.037),其余无统计学意义。 结论:鼻咽癌IMRT过程中正常器官体积剂量会发生一些变化,特别是腮腺变化较明显,建议放疗中后期有必要重新勾画靶区,重新计划,以减小正常器官的受照量和放疗反应。
[Abstract]:Aim: to observe the changes of normal organ volume and dose during intensity modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC) patients by repeated CT scanning and redesign. Methods: IMRT technique was used in 20 patients with nasopharyngeal carcinoma (nasopharyngeal carcinoma, NPC) who received full-course intensity modulated radiotherapy (intensity modulated radiotherapy, IMRT). IMRT technique was used in nasopharyngeal carcinoma (NPC), neck and supraclavicular region. Plan 1 was designed according to IMRT procedure and DVH1. was obtained. At 20 times of radiotherapy, the patient re-scanned the CT according to the original fixed position and reference coordinates, copied the plan 1 to the redrawn target generation plan 1, and DVH1-2, re-designed the second CT scan to get the plan 2 and get the DVH2.. The volume doses of normal organs before and after 20 times of radiotherapy were analyzed by CT and DVH. Results: compared with Plan 1, the volume of left and right parotid glands in Plan 1 / 2 was significantly smaller than that in DVH1 (P0.05). The maximum dose, average dose, D50 and V35 of the left and right parotid glands, the maximum dose of spinal cord, the average dose and the D1cc of the left and right parotid glands were significantly increased (P0.05). The maximum dose of brain stem (P0. 011) and the dose increase of parotid gland were closely related to the weight loss, silhouette reduction and parotid volume reduction induced by radiotherapy. There was a certain correlation between the maximum dose of spinal cord and the degree of reduction of left and right contours (r = 0.469, p = 0.037), but there was no statistical significance in the rest. Conclusion: there are some changes in the volume dose of normal organs during IMRT, especially in parotid gland. It is suggested that it is necessary to redraw and plan the target area in the middle and late stage of radiotherapy in order to reduce the irradiation dose and radiation response of normal organs.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.63
本文编号：2448629
[Abstract]:Aim: to observe the changes of normal organ volume and dose during intensity modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC) patients by repeated CT scanning and redesign. Methods: IMRT technique was used in 20 patients with nasopharyngeal carcinoma (nasopharyngeal carcinoma, NPC) who received full-course intensity modulated radiotherapy (intensity modulated radiotherapy, IMRT). IMRT technique was used in nasopharyngeal carcinoma (NPC), neck and supraclavicular region. Plan 1 was designed according to IMRT procedure and DVH1. was obtained. At 20 times of radiotherapy, the patient re-scanned the CT according to the original fixed position and reference coordinates, copied the plan 1 to the redrawn target generation plan 1, and DVH1-2, re-designed the second CT scan to get the plan 2 and get the DVH2.. The volume doses of normal organs before and after 20 times of radiotherapy were analyzed by CT and DVH. Results: compared with Plan 1, the volume of left and right parotid glands in Plan 1 / 2 was significantly smaller than that in DVH1 (P0.05). The maximum dose, average dose, D50 and V35 of the left and right parotid glands, the maximum dose of spinal cord, the average dose and the D1cc of the left and right parotid glands were significantly increased (P0.05). The maximum dose of brain stem (P0. 011) and the dose increase of parotid gland were closely related to the weight loss, silhouette reduction and parotid volume reduction induced by radiotherapy. There was a certain correlation between the maximum dose of spinal cord and the degree of reduction of left and right contours (r = 0.469, p = 0.037), but there was no statistical significance in the rest. Conclusion: there are some changes in the volume dose of normal organs during IMRT, especially in parotid gland. It is suggested that it is necessary to redraw and plan the target area in the middle and late stage of radiotherapy in order to reduce the irradiation dose and radiation response of normal organs.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.63
【参考文献】
相关期刊论文 前5条
1 张恩罴,钱剑扬,崔念基,卢泰祥,夏云飞,胡永红,罗伟;改进鼻咽癌外照射技术的前瞻性临床研究[J];癌症;2000年09期
2 崔世军;张建;俞恒锡;谷涌泉;李建新;滕旭;武文琦;祁雅慧;汪忠镐;;VEGF及bFGF基因治疗家兔肢体缺血的实验研究[J];北京医学;2007年08期
3 张书旭,徐海荣,林生趣,李文华;鼻咽癌调强放疗和常规放疗受照剂量对比分析[J];第一军医大学学报;2004年08期
4 袁智勇;高黎;徐国镇;易俊林;黄晓东;罗京伟;李素艳;戴建荣;;初治鼻咽癌调强放疗的初步结果[J];中华放射肿瘤学杂志;2006年04期
5 罗健,储大同;评价生活质量在中医药治疗恶性肿瘤中的作用[J];中华肿瘤杂志;2002年04期
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