摘要
目的 :本研究旨在探讨呼吸门控技术应用于放疗的可靠性,以及降低急性放射性肺炎发生率的可能性。方法 :随机抽取10例呼吸平稳的门控肺癌患者在首程治疗和缩野时分别于计划前后接受2次四维CT,研究外在模拟信号与靶区真实运动的对应性和稳定性。人为改变呼吸参数,研究门控剂量分布的符合性和系统鲁棒性。通过引入相靶区的概念,研究门控技术对靶区体积的减少作用。对88例下叶肺癌患者行随机分组研究,比较放射性肺炎的发生率。结果 :研究提示呼吸门控系统具有较好的鲁棒性。在靶区剂量体积直方图保持相等的条件下,相靶区体积以及V5、V20和V30值均显著降低,有统计学意义(P<0.05)。初步临床研究结果显示,门控和非门控技术下,≥Ⅱ级急性放射性肺炎的发生率分别为4.76%和17.39%。结论 :在门控放疗中引入相靶区的概念,可使靶区的命名更为合理。对于小野移动靶区的放疗,需要采用呼吸管理技术。
Objective： This article focuses on the reliability study on clinical application of respiratory gating technique, and to explore whether the incidence of acute radiation pneumonitis is reduced when gated radiotherapy is performed. Methods： Ten lung cancer patients with smooth respiratory movement were randomly enrolled among those who needed treatment with real-time position management （RPM）. These patients received 4D cine scan CT over two sessions during the course of treatment. The second session was the reduced field boost. The dose distribution conformance and system＇s robustness for gated radiation treatments via artificially changing the respiratory parameters were studied. To study the target volume reduction due to gating, a new term named phase target volume was introduced. A total radiotherapy, and the incidence of radioactive of 88 lower lobe lung cancer patients received pneumonia was evaluated Results： Studies suggested that the system has good robustness. In the condition of equal dose-volume histogram （DVH）, the phase target volume and V5, V20 and V30 values were significantly reduced. Preliminary clinical results showed that the incidence rates of acute radioactive pneumonia （≥gradeⅡ） of gated and non-gated radiotherapy were 4.76% and 1 7.39%, respectively. Conclusion： The introduction of the concept of phase target zone in gated radiotherapy will make the target area more reasonable. For the radiotherapy of small field moving target, the respiratory management technology is needed.
出处
《肿瘤》
CAS
CSCD
北大核心
2017年第1期58-64,共7页
Tumor
关键词
肺肿瘤
呼吸门控放疗
靶区移动
相靶区
Lung neoplasms
Respiratory gating radiotherapy
Target moving
Phasetarget volume
