摘要
目的:通过分析非小细胞肺癌(NSCLC)放疗实施过程中的肿瘤运动幅度,为靶区外放边界提供参考。方法:回顾性分析行立体定向放射治疗(SBRT)的NSCLC患者30例的临床资料,其中上叶和中下叶肿瘤各15例,定位时行4D-CT呼吸门控技术确定患者呼吸时相勾画靶区。患者每次放疗前行4D-CBCT图像扫描,获得X轴(左右)、Y轴(上下)、Z轴(前后)三个方向的肿瘤最大运动范围Mask(A)值,用统计学分析计算肿瘤运动幅度和靶区外放边界。结果:上叶和中下叶肿瘤在X(P=0.072)、Z(P=0.152)方向运动差异无统计学意义,X、Z方向肿瘤运动幅度分别为(0.17±0.12)cm、(0.25±0.14)cm,对应靶区外放边界分别为0.30 cm、0.34 cm;上叶和中下叶肿瘤在Y方向运动幅度分别为(0.35±0.21)cm、(1.05±0.53)cm,差异具有统计学意义(P=0.000),对应靶区外放边界为0.57cm、1.34cm。结论:上叶和中下叶非小细胞肺癌在X、Z方向的肿瘤运动幅度无差异,靶区外放边界较小;在Y方向的肿瘤运动幅度有较明显差异,中下叶明显大于上叶,应扩大中下叶肿瘤的靶区外放边界以适合肿瘤的实际运动幅度,实现放疗计划个体化精准设计的目的。
Objective Analysis of the tumor motion of NSCLC(non-small cell lung cancer) during radiotherapy, to provide a reference for the target margins.Method A retrospective study of 30 NSCLC patients who received SBRT(stereotactic body radiation therapy), including 15 cases of the upper lobe tumors and the middle or lower lobe tumors. 4 D-CT respiratory gating technology determines the patient’s respiration phase to delineate the target margins. 4 D-CBCT were performed before radiotherapy. Obtain the mask(A) of the maximum range of tumor motion on X-axis(left-right), Y-axis(superior-inferior), and Z-axis(anterior-posterior). Statistical analysis was used to calculate the tumor motion and the target margins.Results The upper lobe tumors and the middle or lower lobe tumors had no statistically difference in the motion of the X-axis(P=0.072) and Z-axis(P=0.152). The tumor motion in the X-axis and Z-axis are(0.17±0.12) cm and(0.25±0.14) cm, and the target margins were 0.30 cm and 0.34 cm;The upper lobe tumors and the middle or lower lobe tumors motion was different on the Y-axis with(0.35±0.21) cm and(1.05±0.53) cm(P=0.000), and the target margins were 0.57 cm, 1.34 cm.Conclusion There is no difference in the tumor motion of the upper lobe and the middle or lower lobe NSCLC in the X-axis and Z-axis, and the target margins is small;The tumor motion in the Y-axis is significantly different, and the middle or lower lobe tumor motion is significantly greater than the upper lobe, and the target margins of the middle or lower lobe should be enlarged to suit the actual tumors motion, to achieve the purpose of individualized and precise design of radiotherapy plans.
作者
麻亚茹
周姝含
林茂盛
MA Ya-ru;ZHOU Shu-han;LIN Mao-sheng(Department of Radiation Oncology,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)
出处
《吉林医学》
CAS
2022年第10期2772-2774,共3页
Jilin Medical Journal
关键词
肿瘤运动幅度
外放边界
非小细胞肺癌
放射治疗
Amplitude of tumor motion
Extravasation borders
Non-small cell lung cancer
Radiation therapy
