鼻咽癌斜坡侵犯MRI表现与IMRT靶区勾画的关系  

Relationship between MRI Features of Clivus Invasion and Target Delineation for IMRT in Nasopharyngeal Carcinoma

作　　者：胡望远[1] 周玲[1] 杨昕[1] 李斌[2] 姜峰[2] 秦卫丰[2] 冯星来[2] 陈晓钟[2] 

机构地区：[1]金华市中心医院,浙江金华321000 [2]浙江省肿瘤医院,浙江杭州310022

出　　处：《肿瘤学杂志》2010年第2期119-122,共4页Journal of Chinese Oncology

基　　金：金华市科技创新重点项目(2007-03-010)

摘　　要：[目的]分析总结鼻咽癌(NPC)斜坡侵犯的MRI表现与IMRT靶区勾画的关系。[方法]100例经确诊初治无处远转移的鼻咽癌病例,所有病例放疗前均接受MRI检查并分析斜坡信号异常及浸润范围。选取5例斜坡侵犯者进行IMRT靶区勾画及计划设计,其GTVnx后缘分别按斜坡前缘、斜坡1/2、斜坡后缘三个解剖位置进行勾画,分析靶区勾画位置与等剂量曲线包容的相关性。[结果]100例中有62例斜坡异常。三个不同解剖位置GTV后缘距脑干的最短平均距离分别为16.0mm、11.5mm、7.0mm。GTVnx被100%的处方剂量(7200cGy)包绕的体积百分比分别为95%、91%、85%。[结论]NPC斜坡侵犯MRI表现较为复杂,勾画靶区时应充分考虑不同MRI表现,根据信号异常的程度和范围给予不同处方剂量。[Purpose] To investigate the relationship between MRI features of clivus invasion and the target delineation for IMRT in nasopharyngeal carcinoma（NPC）.[Methods] One hundred NPC patients without metastasis were underwent MRI scan before radiotherapy,abnormal signal of clivus and infiltrative range were analyzed.Five cases with clivus invasion taken IMRT target delineation and radiotherapy plan.The primary gross tumor volume（GTVnx） was delineated near the foreside,in the middle and near the rear side of the clivus,the relationship between position of target delineation and isodose curve was analyzed.[Results] Of the 100 cases there were 62 cases with abnormal signal of clivus.The average shortest distance（GTVnx to brainstem） of the 3 different anatomical locations was 16.0mm,11.5mm and 7.0mm respectively.The volume percentage of GTVnx surrounded by 100% prescription dose（7200cGy） was 95%,91%,85%,respectively.[Conclusions] MRI features of clivus invasion in NPC is complex.The different MRI features should be fully considered while target delineation.Different prescription dose depends on the degree and extent of signal abnormalities.

关 键 词：鼻咽肿瘤 斜坡 MRI 调强放射治疗 靶区勾画 

分 类 号：R739.63[医药卫生—肿瘤]