两种减少呼吸运动方法在非小细胞肺癌放疗靶区勾画中的应用

发布时间：2018-05-02 03:48

  本文选题：肺癌 + 主动呼吸控制　； 参考：《中华实用诊断与治疗杂志》2016年07期

【摘要】：目的探讨肺癌放疗靶区勾画中主动呼吸控制(active breathing control,ABC)技术配合四维CT、简易腹部加压(simple manual epigastric compression,SMEC)技术配合四维CT对肺活动度、肺部放疗体积的影响。方法 50例非小细胞肺癌患者随机分为主动呼吸组27例,腹部加压组23例,主动呼吸组行ABC技术扫描和自由呼吸扫描,腹部加压组行SMEC技术和自由呼吸扫描,重建扫描图像后进行靶区勾画。比较ABC技术与自由呼吸扫描,SMEC技术和自由呼吸扫描模式下肺肿瘤左右(right-left,RL)、头脚(superior-inferior,SI)、前后(anterior-posterior,AP)运动幅度,依据剂量体积直方图评价两种技术双肺V_5、V_(10)、V_(20)、V_(30)剂量体积及总剂量体积(V_总)。结果主动呼吸组ABC扫描下肺肿瘤SI运动幅度[(5.04±0.64)mm]低于自由呼吸扫描[(15.58±0.71)mm](P0.05),RL、AP运动幅度与自由呼吸扫描比较差异无统计学意义(P0.05);腹部加压组SMEC技术扫描下肺SI运动幅度[(5.18±1.12)mm]低于自由呼吸扫描[(16.14±2.21)mm](P0.05),RL、AP运动幅度与自由呼吸扫描比较差异无统计学意义(P0.05);主动呼吸组ABC扫描下双肺V_5、V_(10)、V_(20)、V_(30)[(52.74±4.78)%、(38.76±4.92)%、(23.71±4.03)%、(15.54±3.43)%]均低于自由呼吸扫描[(62.54±5.63)%、(45.58±5.84)%、(29.02±5.10)%、(19.18±4.61)%](P0.05),V_总[(3 725.00±184.41)cm3]高于自由呼吸扫描[(3 125.00±219.92)cm3](P0.05);腹部加压组SMEC扫描下双肺V_5、V_(10)、V_(20)、V_(30)、V_总[(61.47±4.93)%、(43.89±4.74)%、(27.38±3.97)%、(17.77±3.56)%、(3 475.00±214.12)cm3]均低于自由呼吸扫描[(62.54±5.61)%、(45.58±5.40)%、(29.00±5.11)%、(19.18±4.62)%、(3 567.00±235.31)cm3](P0.05);ABC扫描时SI、AP运动幅度与SMEC技术扫描比较差异无统计学意义(P0.05),RL运动幅度低于SMEC技术扫描(P0.05);ABC扫描时V_5、V_(10)、V_(20)、V_(30)低于SMEC技术扫描,V总高于SMEC技术扫描(P0.05)。结论 ABC、SMEC技术配合四维CT均可有效减小肺肿瘤SI方向的呼吸动度,ABC技术在肺癌放疗靶区勾画中缩小V_5、V_(10)、V_(20)剂量体积及增加V总上效果明显。
[Abstract]:Objective to investigate the effects of active breathing control (ABC) technique combined with four-dimensional CTC and simple manual epigastric compression technique (SMC) combined with four-dimensional CT (Four-dimensional CT) on lung activity and lung radiation volume in lung cancer radiotherapy target. Methods Fifty patients with non-small cell lung cancer were randomly divided into active breathing group (n = 27) and abdominal compression group (n = 23). ABC scanning and free breathing scanning were performed in active breathing group and SMEC technique and free breathing scan were performed in abdominal compression group. The image was reconstructed and the target area was delineated. To compare the range of motion between ABC technique and free respiratory scanning (SMEC) technique and free breath scanning mode, and to evaluate the dose volume and total dose volume of V5V10VC20 / VDV) in bilateral lung V5V10V10V / V ~ (30) by comparing the amplitude of motion of left and right left side of lung tumor, head and foot of superior inferiorus siella, anterior and posterior anterior posteriorus under the mode of free breath scanning and free breathing scanning. The two techniques were used to evaluate the dose volume and the total dose volume of V5V10VC20 / VDV in the two kinds of techniques according to the dose-volume histogram. Results the SI motion amplitude of lung tumor in active breathing group [5.04 卤0.64)mm] was lower than that in free breath scan [15.58 卤0.71)mm] P0.05RLAP, there was no significant difference between P0.05 and free breathing scan, and the SI motion amplitude of lung in abdominal compression group was 5.18 卤1.12)mm under SMEC scanning. 浜庤嚜鐢卞懠鍚告壂鎻廩(16.14卤2.21)mm](P0.05),RL,AP杩愬姩骞呭害涓庤嚜鐢卞懠鍚告壂鎻忔瘮杈冨樊寮傛棤缁熻�″�︽剰涔，

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