放疗期间危及器官中的亚结构保护新策略  

Novel Strategy for Sparing Substructures in Organs at Risk during Radiation Therapy

作　　者：李俊玉[1] 李莹[1] 谭文勇[1] 

机构地区：[1]湖北省肿瘤医院放疗中心,武汉430079

出　　处：《肿瘤防治研究》2014年第5期482-487,共6页Cancer Research on Prevention and Treatment

基　　金：湖北自然科学基金资助课题(2013CFB059)

摘　　要：在放疗中正常组织器官各个部位的功能和放疗反应性不同,其空间异质性未得到充分考虑;随着影像学、放疗技术和放射生物学的进步,调强放疗技术可以更好保护危及器官中的重要结构。本文着重分析在调强放疗中保护分析部分重要结构的可行性,这些重要结构包括:大脑中重要功能区域、神经核团、神经纤维束;放疗相关唾液腺、吞咽功能障碍相关的头颈部结构;心脏、肺部的重要解剖结构。在调强放疗中对重要解剖功能区进行定义并设定适当的剂量体积参数进行优化,可达到在不牺牲靶区剂量的前提下更好的保护危及器官。During radiotherapy, for a single organ, the anatomical and spatial heterogeneity to radiation response is usually not taken into consideration. With the development of imaging, radiation techniques and radiobiology, intensity-modulated radiotherapy may spare functional substructures in the organs. In this review, various critical functional structures were addressed and these functional substructures including the critical brain structure, neural nuclei and nerve fiber tracts in the central nervous system, head and neck structures related to radiation-induced salivary and swallowing dysfunction, and functional substructures in lung and heart. During intensity-modulated radiotherapy, the dose-volume constraints could be set individually to minimize the radiation dose and(or) irradiated volume of various substructures without compromising the dose coverage to target volume.

关 键 词：危及器官 调强放疗 亚结构 心脏保护 中枢神经系统肿瘤 头颈部肿瘤 胸部肿瘤 

分 类 号：R730.55[医药卫生—肿瘤]