摘要
目的研究鼻咽癌患者左右腮腺体积和位置在容积旋转调强放疗期间的动态变化规律。方法选择行容积旋转调强放疗的20例鼻咽癌患者,每5次放疗行CBCT扫描。参考CBCT影像,分析左、右腮腺的体积和位移变化。结果放疗期间腮腺体积逐渐减小;左侧腮腺放疗末期总体缩小31.50%,平均每周缩小5.25%;右侧腮腺总体缩小28.88%,平均每周缩小4.81%。放疗前至放疗3周,左右侧腮腺体积差异无统计学意义(P>0.05);放疗4周后,左右侧腮腺体积差异有统计学意义(P<0.05)。双侧腮腺体积的缩小与放疗前初始体积有显著相关性,放疗前左侧腮腺原始体积比右侧略大,则随着疗程的增加,体积缩小的更多。放疗末期左侧腮腺X、Y、Z方向移动了(-1.52±2.03)、(-0.67±3.03)、(-2.82±2.17)mm,右侧腮腺X、Y、Z方向移动了(1.11±2.20)、(-0.42±3.14)、(-1.91±2.0)mm。结论左右两侧腮腺在放疗进程至4周后,体积缩小差异显著。腮腺中心位置表现为向身体内侧、后侧移动。此时为鼻咽癌患者调整容积旋转调强放疗计划的最佳时机提供参考,以缓解患者口干症状,提高其放疗生活质量。
Objective To study the rule of parotids dynamic variation in volumetric-modulated arc therapy(VMAT)of nasopharynx cancer.Methods A total of 20 patients with nasopharynx cancer who received VMAT were selected and CBCT scanning was arranged after every 5 fractions.The volume and center shift of left and right parotids were analyzed based on the CBCT images.Results Parotid gland volume decreased gradually during radiotherapy.At the end of radiotherapy,the volume of left parotid was reduced by 31.50%,with an average weekly reduction of 5.25%.The right parotid gland shrank by 28.88%overall and 4.81%on average per week.There was no significant difference in the volume of left and right parotid glands during the first 3 weeks of radiotherapy(P>0.05).After 4 weeks of radiotherapy,the volume difference of left and right parotid glands was statistically significant(P<0.05).The reduction of parotids volume was significantly correlated with the initial volume before radiotherapy.Before radiotherapy,the original volume of left parotid gland was slightly larger than that of right parotid gland,but with the increase of treatment course,the volume decreased more.At the end of radiotherapy,the center of left parotid gland moved(-1.52±2.03),(-0.67±3.03)and(-2.82±2.17)mm in the X,Y and Z directions,while the center of right parotid gland moved(1.11±2.20),(-0.42±3.14)and(-1.91±2.0)mm in the X,Y and Z directions.Conclusion After 4 weeks of radiotherapy,the difference between the left and right parotids volume reduction was significantly and the centers of left and right parotids were shifted to the inner and back of body.This provides a reference for the optimal time to adjust VMAT plan for nasopharyngeal carcinoma patients,so as to relieve dry mouth symptoms of patients and improve their radiotherapy quality of life.
作者
罗丹
庄小捷
余双
彭黎明
曾佳
余俊
LUO Dan;ZHUANG Xiaojie;YU Shuang;PENG Liming;ZENG Jia;YU Jun(Radiotherapy Room Yichun People’s Hospital,Yichun Jiangxi 336000,China;Department of Oncology,Yichun People’s Hospital,Yichun Jiangxi 336000,China)
出处
《中国医疗设备》
2020年第S01期50-52,共3页
China Medical Devices
基金
江西省宜春市科技计划指导性项目(JXYC2019KSB010)
江西省卫生健康委科技计划项目(20203571)。
关键词
鼻咽癌
容积旋转调强放疗
腮腺体积
位移
口干症
nasopharynx cancer
volumetric-modulated arc therapy
parotids
displacement
xerostomia
