离线自适应在食管癌放射治疗中的临床应用

发布时间：2017-12-28 13:19

本文关键词：离线自适应在食管癌放射治疗中的临床应用　出处：《安徽医科大学学报》2016年05期 　论文类型：期刊论文

【摘要】：收集未行手术的食管癌初治患者行自适应放射治疗,分别采集每位患者第1次放疗前、第8次放疗后和第16次放疗后的CT扫描图像勾画靶区,制定P1、P2、P3 3次治疗计划。通过比较3次计划间计划靶区(PTV)体积与剂量学差异、危及器官受照剂量学差异来观察并探讨自适应放疗在食管癌治疗上的临床价值。结果显示,3组计划中,靶区体积及靶区剂量差异无统计学意义,但平均剂量(D_(mean))有逐渐增大并接近计划剂量64 Gy的趋势。靶区的剂量均匀性指数(HI)、靶区适形度指数(CI)差异均无统计学意义,但Cl值有逐渐增大并接近1的趋势;心脏V_(40)差异无统计学意义。双肺V_5、V_(10)、V_(20)、V_(30)差异无统计学意义。脊髓D_(max)差异有统计学意义(P=0.013)。表明食管癌的离线自适应放疗对靶区剂量及体积影响不明显,但对危及器官脊髓保护较好。
[Abstract]:Collect the untreated esophageal cancer patients who received initial radiotherapy, then take the adaptive radiotherapy, collect first patients' CT scan images before and after eighth times of radiotherapy and sixteenth times of radiotherapy, respectively, and plot the target area, and formulate 3 treatment plans of P1, P2 and P3. The clinical value of adaptive radiotherapy in the treatment of esophageal cancer was observed and compared by comparing the difference between the 3 planned target area (PTV) volume and dosimetric difference, and the dosimetric difference of organs exposed to radiation. The results showed that there was no significant difference in target volume and target dose between the 3 groups, but the average dose (D_ (mean)) increased gradually and approached the planned dose of 64 Gy. There was no significant difference in target dose uniformity index (HI) and target area conformability index (CI), but the Cl value increased gradually and approached 1. There was no significant difference in heart V_ (40). There was no significant difference in V_5, V_ (10), V_ (20), and V_ (30) in both lungs. The difference of D_ (max) in the spinal cord was statistically significant (P=0.013). It shows that the effect of off-line adaptive radiotherapy on target area dose and volume is not obvious, but it is good for the protection of organ spinal cord.
【作者单位】：安徽医科大学第一附属医院肿瘤放疗科;安徽中医药大学第一附属医院肿瘤科;
【基金】：安徽高校省级自然科学研究项目(编号:KJ2010A170)
【分类号】：R735.1;R730.55
【正文快照】： 放射治疗栜管~尣q栜之-,柋疗(IGRT)等精确放疗技术较好地解决了静止状态下靶区的新性麟匀性,但_栜疗过程帽;及体内器S(0atnS巧k,OAR)照里重新分布进而一向测量剂量健,修IE治时测戄体化断方案⑴。在线art需要时间长、对技术设备要求高难于在临床上魏r>侧用楙氃榞于媭

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