非小细胞肺癌自适应放疗剂量学研究  

Dosimetry study of adaptive radiotherapy in non-small cell lung cancer

作　　者：陈龙[1] 谢小妹[2] 黄江琼[1] 付庆国[1] 张晓静[1] 朱小东[1] 梁霞[1] 

机构地区：[1]广西医科大学附属肿瘤医院放疗科,南宁530021 [2]广西医科大学研究生学院

出　　处：《中国癌症防治杂志》2012年第1期53-56,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：广西自然科学基金资助项目(2011jjA40272;桂科基0448065)

摘　　要：目的在非小细胞肺癌中,评估及比较大分割三维适形放疗计划(CT-3DCRT)及应用CBCT图像设计自适应放疗计划(CBCT-ART)在剂量学上的变化,为临床选择最佳治疗策略提供依据。方法对我院2010年6月至2011年10月收治的10例应用大分割3DCRT的非小细胞肺癌患者,每次放疗前进行一次CBCT验证,并应用CBCT图像设计与治疗前(CT-3DCRT)相似的CBCT-ART计划,通过剂量体积直方图评价二者对靶区及正常组织受照剂量的影响。结果在CBCT-ART计划中,患侧肺V20为(9.5±3.45)%,脊髓Dmax为(25±12.7)Gy,而在CT-3DCRT计划中分别为(11.5±3.5)%、(27±13.2)Gy,自适应放疗计划较三维适形放疗计划可明显降低正常组织受量(P<0.05)。结论根据分次CBCT图像所示靶区变化进行再计划,可以明显减少周围正常组织器官受量,从而可进一步提高靶区剂量,提高局部控制率。Objective To evaluate and compare the dosimetry achieved using three-dimensional conformal radiotherapy（CT-3DCRT） with that achieved using cone-beam computer tomography adaptive radiotherapy（CBCT-ART） in patients with non-small cell lung cancer,in order to provide a basis for selecting the best clinical treatment strategy.Methods Ten patients with non-small cell lung cancer were treated in our hospital between June 2010 and October 2011,first using hypofractionated CT-3DCRT,with CBCT verifi-cation performed before each fraction,and then using CBCT-ART.Dosimetry of target and normal tissue was compared between the two CT approaches using dose-volume histograms.Results In the CBCT-ART approach,V20 of the affected side of the lung was（9.5±3.45）% and the Dmax of the spinal cord was（25±12.7） Gy,while the corresponding values in the CT-3DCRT approach were（11.5±3.5）% and（27±13.2） Gy（P0.05）.Adaptive radiotherapy can significantly reduce the radiation exposure of normal tissue compared with three-dimensional conformal radiotherapy.Conclusion Using target volume changes in each CBCT image to adjust the dosing regime can significantly reduce the radiation exposure of adjacent normal tissue,which may allow use of a higher target dose and sub-sequent improvement in local control.

关 键 词：锥形束CT 自适应放射治疗 三维适形放疗 

分 类 号：R734.2[医药卫生—肿瘤]