非小细胞肺癌三维适形放疗中再次CT定位对靶区及正常组织剂量学影响的研究

发布时间：2018-01-06 21:23

本文关键词：非小细胞肺癌三维适形放疗中再次CT定位对靶区及正常组织剂量学影响的研究　出处：《滨州医学院学报》2015年04期 　论文类型：期刊论文

【摘要】：目的研究非小细胞肺癌(NSCLC)放疗过程中再次CT定位及相应放疗计划修改对肿瘤区及正常组织剂量学影响。方法对53例经病理证实的NSCLC患者放疗过程中进行再次定位,根据肿瘤及肺体积变化,修改放疗计划,通过拟合两次计划,分析叠加的剂量体积参数,与不修改的放疗计划的剂量体积参数比较。结果放疗计划修改前照射次数为(20.0±4.2)次,计划修改后GTV缩小了(71.98±34.6)cm3,且GTV变化与计划修改前照射次数呈正相关关系,r=0.497,P=0.006。最初设计的总计划与再次CT设计的计划拟合后患侧肺和全肺的平均受量分别下降了(4.6±10.1)%、(4.1±8.7)%,P值分别为0.03和0.02。拟合叠加计划与初次总的计划比较,心脏的V30受照射剂量下降了(2.68±1.3)%,脊髓的Dmax下降了(12.4±2.8)%。结论三维适形放疗中肿瘤体积发生退缩,可以适时地修改放疗计划以减少正常组织的受照射剂量,从而可以推量照射以提高肿瘤的受照射剂量。
[Abstract]:Objective to study the non-small cell lung cancer (NSCLC) and the corresponding location again CT radiotherapy during radiotherapy modification effect on tumor area and normal tissue dosimetry. Methods 53 cases of re positioning process of NSCLC radiotherapy in patients with pathologically confirmed were, according to the tumor and lung volume changes, modification of radiotherapy plans by fitting two plan analysis of the dose volume parameters. The comparison of dose volume parameters and radiotherapy without modification. The radiotherapy plan changes before irradiation times for (20 + 4.2), revised plan of GTV reduced (71.98 + 34.6) cm3, and the change of GTV and plan to modify before irradiation times were positively correlated, r=0.497, total plan P=0.006. was originally designed and planned fitting of affected side again CT design and whole lung lung mean dose decreased (4.6 + 10.1)% and (4.1 + 8.7)%, P = 0.03 and 0.02. fitting overlay plan and initial total Plan comparison, the heart of the V30 radiation dose decreased (2.68 + 1.3)%, spinal cord Dmax decreased (12.4 + 2.8)%. Conclusion the three-dimensional conformal radiotherapy in tumor volume shrink, can timely modify the radiotherapy plan to reduce the radiation dose to normal tissue, which can boost irradiation to improve radiation the dose of tumor.

【作者单位】：青岛大学医学院附属医院PET-CT中心;滨州医学院附属医院肿瘤科;
【分类号】：R734.2;R730.44
【正文快照】： 肺癌是世界范围内患病率及死亡率均居前列的恶性肿瘤,对人类健康危害严重,其中非小细胞肺癌约占肺癌的80%左右[1]。放化疗是治疗肺癌的主要手段,随着放射治疗技术的飞速发展,放疗的精确性在实施中越来越重要。利用放射治疗计划系统对患者进行放疗计划设计,对肿瘤靶区及周围正

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