迷走右锁骨下动脉对食管癌与肺癌精确放射治疗影响的观察  

Effect of aberrant right subclavian artery on precise radiotherapy to esophageal and lung cancer

作　　者：桑茂忠[1] 徐春丽[2] 王培合[1] 李勇[1] 徐永华[1] 郝福荣[1] 

机构地区：[1]潍坊市人民医院放疗科,山东潍坊261041 [2]中国人民解放军第89医院肿瘤科,山东潍坊261021

出　　处：《中华肿瘤防治杂志》2009年第5期377-380,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨迷走右锁骨下动脉(ARSA)对食管癌和肺癌精确放射治疗靶区与危及器官(OAR)的体积及受照剂量的影响。方法:食管癌或肺癌合并ARSA患者,在相同的射野参数条件下,分别计算ARSA误诊(F组)和正确诊断(R组)时精确放射治疗靶区和OAR的体积及受照剂量。结果:在处方剂量和90%靶区体积的百分处方剂量相近的情况下,ARSA误诊合并食管癌、右肺癌行精确放疗时,可不同程度增加GTV、CTV、PTV体积和受照剂量,及心脏、肺、脊髓受照剂量和脊髓受照长度。在F组中,合并食管癌胸上段的GTV、CTV和PTV体积增加最大,占40%～50%;合并食管癌胸下段的GTV、CTV和PTV平均剂量增加最大,约40%;合并食管癌时,心脏、肺、脊髓的平均剂量增加最大,占30%～85%;合并肺癌时,靶区、心脏、肺、脊髓的各项评价指标变化最小,≤12%。结论:ARSA误诊可以不同程度的增加食管癌和肺癌精确放疗的靶区和OAR的体积及受照剂量。OBJECTIVE： To study the effect of aberrant right subclavian artery（ARSA） on volume and doses of targets or OAR in the process of precise radiotherapy to esophageal or lung cancer. METHODS： The carcinoma patients with ARSA were treated with precise radiotherapy, with the same parameters of beam field, the volumes and doses of targets or OAR were calculated respectively under ARSA misdiagnosed （F group） and correctly diagnosed （R group）. RESULTS： Under the conditions of similar prescribed dose and prescribed dose percentage of 90% target volumes, volumes and doses of GTV, CTV and PTV, doses of heart, lung and spinal cord, and irradiating length to spinal cord were increased differently in the process of precise radiotherapy to esophageal or lung cancer patients with ARSA misdiagnosed. In F grouo, the oatents with thoracic unper esophageal cancer, the volumes increased of GTV, CTV and PTV were most, about 40%-50% the patents with thoracic lower esophageal cancer, the mean doses increased of GTV, CTV and PTV were most, about 40%; the patents with esophageal cancer, the mean do ses increased of heart, lung and spinal cord were most, about 30%- 85%; the patents with lung cancer, the variation of evaluation parameters of target, heart, lung and spinal cord were least, no more than 12%. CONCLUSION： The volumes and doses of targets or OAR can be increased differently in the process of precise radiotherapy to e sophageal or lung cancer patients with ARSA misdiagnosed.

关 键 词：迷走右锁骨下动脉 食管肿瘤 肺肿瘤 精确放射治疗 

分 类 号：R735.1[医药卫生—肿瘤] R734.2[医药卫生—临床医学]