摘要
目的探讨食管癌三维适形放射治疗中靶区移位情况。方法收集2013年1月—2016年12月在甘肃省嘉峪关市酒钢医院放疗科(本院)诊治的食管癌患者30例,所有患者都给予三维适形放射治疗。患者放疗计划完成后,打印0°、90°射野图,随后患者吞钡,在模拟定位机下拍验证片并存档;当放疗完成DT20Gy/10f,DT40Gy/20f,DT60Gy/30f时,分别再次吞钡,在模拟定位机下拍验证片确定精确靶区。并采用CT模拟定位方法进行首次与第2次定位,记录靶区移位情况与放疗2次定位的剂量学参数变化。结果在第2次定位时患者的放疗GTV总体积、长度、最大横径与初次定位相比较,差异具有统计学意义(P<0.05);30例患者中发生靶区移位4例,发生率为13.3%,X轴平均位移为(0.54±0.43)cm,Y轴平均位移为(0.38±0.21)cm,Z轴平均位移为(0.63±0.51)cm。第2次定位时患者的CTV与PTV剂量学参数(D100、D95、D90、V100、V95、V90)与初次定位相比较,差异具有统计学意义(P<0.05)。结论食管癌三维适形放射治疗较大限度的保护食管周围高危器官,提高靶区剂量,放疗过程中靶区移位可使靶区的剂量分布发生变化,需要进行2次定位以修正靶区剂量。
Objective To investigate of patients with esophageal carcinoma during the treatment of three dimensional conformal radiotherapy.Methods From January 2013 to December 2016,30 patients with esophageal cancer diagnosed and treated in the department of radiation oncology(the hospital) of Jiayuguan City were enrolled.All patients were given three dimensional conformal radiation therapy.After the patient’s radiotherapy plan is completed,the 0° and 90° field maps are printed,and then the patient swallows,and the verification film is taken and archived under the simulated positioning machine.When the radiotherapy is completed DT20 Gy/10 f,DT40 Gy/20 f,DT 60 Gy/30 f,it is swallowed again,and the verification film is taken under the analog positioning machine to determine the precise target area.The CT simulation positioning method was used for the first and second positioning,and the changes of the target area and the dose parameters of the radiotherapy were recorded.ResultsAt the second localization,the total volume,length and maximum transverse diameter of the patient’s radiotherapy were statistically significant(P<0.05).In 30 patients,4 cases were displaced in the target area,and the incidence rate was 13.3%,the average displacement of the X-axis is(0.54±0.43)cm,the average displacement of the Y-axis is(0.38±0.21)cm,and the average displacement of the Z-axis is(0.63±0.51)cm.The CTV and PTV dosimetric parameters(D100,D95,D90,V100,V95,V90) of the patients at the second localization were statistically significant compared with the primary localization(P<0.05).Conclusion Three dimensional conformal radiotherapy for esophageal cancer can protect the high-risk organs around the esophagus to a large extent,and increase the dose of the target area.The target area shift during radiotherapy can change the dose distribution of the target area,so the second positioning are needed to correct the target area.
作者
张延军
王凯
马瑞
王瑾瑜
魏世鸿
ZHANG Yanjun;WANG Kai;MA Rui;WANG Jinyu;WEI Shihong(Department of Radiation Oncology,Jiugang Hospital of Jiayuguan City,Jiayuguan 353100;Department of Radiation Oncology,Gansu Cancer Hospital,Lanzhou 730050,China)
出处
《国外医学（医学地理分册）》
CAS
2019年第3期286-289,共4页
Foreign Medical Sciences：Section of Medgeography
基金
甘肃省科技厅科技支撑计划项目(No.1604FKCA109)
关键词
食管癌
三维适形放射治疗
靶区移位
靶区剂量
esophageal cancer
three dimensional conformal radiotherapy
target area shift
target dose
