螺旋断层放疗图像引导策略的优化探讨

发布时间：2018-01-30 22:05

本文关键词： 螺旋断层治疗 MVCT 摆位误差扫描频次　出处：《中山大学学报(医学科学版)》2017年06期 　论文类型：期刊论文

【摘要】：【目的】探讨螺旋断层放疗(TOMO)时行不同频次图像引导之间的差异,探寻合适的图像引导策略。【方法】选取我中心2015年1月1日~2016年5月15日收治的头颈部肿瘤患者88例、胸腹部肿瘤患者63例、盆腔肿瘤患者19例,均接受TOMO治疗,每次治疗前均行兆伏级CT(MVCT)扫描进行,收集前五次和每周第一次的摆位误差,分别和整个疗程的摆位误差进行比较研究。【结果】胸腹组和盆腔组不同频次扫描之间的摆位误差比较无统计学差异,头颈组前五次扫描和整个疗程的比较中前后方向的摆位误差有统计学意义(P0.05),其他对比的差异无统计学意义。【结论】胸腹部肿瘤和盆腔肿瘤放射治疗时,可考虑前五次扫描或每周一次扫描的方式来代替每天一次扫描,减少患者受到的额外辐射剂量。头颈部肿瘤放射治疗时,前五次的扫描的前后方向误差跟整个疗程误差比较存在明显差异,不能以此为据来指导后续的日常摆位,可以考虑采用每周扫描一次MVCT的方案来代替每天扫描一次的方案。
[Abstract]:[objective] to explore the difference of different frequency image guidance in spiral tomography radiotherapy (TPM). [methods] 88 patients with head and neck tumors and 63 patients with chest and abdomen tumors were selected from January 1st 2015 to May 15th 2016 in our center. All 19 patients with pelvic tumor were treated with TOMO. The first five times and the first time of each week were collected by omega volt CT scan before each treatment. [results] there was no statistical difference between chest and abdomen group and pelvic group in different frequency scanning errors. Head and neck group in the first five scans and the whole course of the comparison of the front and rear direction of the position error was statistically significant (P 0.05). There is no significant difference in other contrasts. [conclusion] radiotherapy for chest and abdomen tumors and pelvic tumors may consider the first five scans or weekly scans instead of daily scans. Reduction of the additional radiation dose to patients. There were significant differences in the front and back direction errors between the first five scans and the whole course of treatment during radiotherapy for head and neck tumors. Instead of using this as a guide for future daily placement, we can consider a weekly scan of MVCT instead of a daily scan.
【作者单位】：华南国家肿瘤实验室//中山大学肿瘤防治中心放疗科;中山大学附属第一医院放射治疗科;
【基金】：广东省医学科学技术研究基金(A2017613)
【分类号】：R730.55
【正文快照】： 放射治疗是恶性肿瘤的重要治疗手段之一[1]。螺旋断层放射治疗(tomotherapy,TOMO)是目前最为先进的调强放射治疗方式,集IMRT(Im-age guide radiation therapy,影像引导放射治疗)和IGRT(Intensity modulated radiation therapy,调强放射治疗)于一体,其兆伏级计算机断层扫描(meg

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