非小细胞肺癌PET-CT定位同步加量调强放射治疗的剂量学研究  

A Dosimetric Research on PET-CT Positioned SMART of NSCLC

作　　者：温翠侠[1] 任洪荣[1] 丁纪[1] 于大海[1] 管峦[1] 朱峰[1] 章龙珍[2] 

机构地区：[1]徐州市中心医院,221009 [2]徐州医学院附属医院,221000

出　　处：《实用癌症杂志》2012年第6期645-648,共4页The Practical Journal of Cancer

摘　　要：目的评价非小细胞肺癌PET-CT定位同步加量调强放射治疗(SMART)的剂量学特点。方法ⅢA、ⅢB期非小细胞肺癌患者10例,分别于单纯增强CT图像下、PET-CT融合图像下勾画靶区,同一患者制定3种放疗计划:PET-CT图像下制定SMART计划(A组)、CT图像下制定SMART计划(B组)和3D-CRT计划(C组),评价3种放疗计划靶区、周围正常组织剂量分布情况。结果 A、B、C组GTV适形度指数分别为0.72±0.03、0.72±0.02、0.65±0.02,CTV适形度指数分别为0.64±0.03、0.64±0.02、0.53±0.03,GTV均匀性指数分别为1.14±0.02、1.15±0.02、1.12±0.02,经检验A、B组与C组比较有统计学意义(P均<0.05),A组与B组比较无统计学意义(P>0.05)。A、B、C组正常肺组织V5分别为53.41±4.90、56.09±4.61、55.87±4.27,V10分别为33.56±4.02、35.95±3.35、36.36±3.57,经检验A组与B、C组比较有统计学意义(P均<0.05),B组与C组比较无统计学意义(P>0.05)。A、B、C组正常肺组织V20分别为23.47±2.10、25.69±2.15、27.69±2.07,V30分别为15.19±2.59、16.10±2.57、17.23±2.35,MLD(Gy)分别为12.58±1.23、13.62±1.19、14.21±1.20,食管V55分别为14.44±1.99、15.29±2.52、16.12±2.50,脊髓Dmax分别为37.45±2.39、39.38±2.78、40.13±2.52,经检验,A、B、C组间比较均有统计学意义(P均<0.05)。结论非小细胞肺癌PET-CT定位SMART计划能优化靶区剂量分布,有效减少靶区周围正常组织受照剂量/体积。Objective To evaluate the dosimetric characteristics of PET-CT positioned SMART of NSCLC.Methods Target volumes of 10 cases of ⅢA and ⅢB NSCLC patients were sketched based on simple CT image and PET-CT image respectively.3 radiotherapy plans were made for every patients：SMART on PET-CT image（Group A）,SMART on CT image（Group B） and 3D-CRT on CT image（Group C）.The dose distribution on the target volumes and surrounding normal tissues of the three groups were evaluated.Results The conformity indexes of GTV in Group A、B and C were respectively 0.72±0.03,0.72±0.02,0.65±0.02.The conformity indexes of CTV were 0.64±0.03,0.64±0.02,0.53±0.03.The homogeneity indexes of GTV were 1.14±0.02,1.15±0.02,1.12±0.02.There were statistical differences between Group A and C,Group B and C（P0.05）.There was no statistical difference between Group A and B（P0.05）.The V5 of normal lung tissue in Group A、B and C were respectively 53.41±4.90,56.09±4.61,55.87±4.27.The V10 were 33.56±4.02,35.95±3.35,36.36±3.57.There were statistical differences between Group A and B,Group A and C（P0.05）.There was no statistical difference between Group B and C（P0.05）.The V20 of normal lung tissue in Group A、B and C were respectively 23.47±2.10,25.69±2.15,27.69±2.07.The V30 were 15.19±2.59,16.10±2.57,17.23±2.35.The MLD（Gy） were 12.58±1.23,13.62±1.19,14.21±1.20.The V55 of esophagus were 14.44±1.99,15.29±2.52,14.21±1.21.The maximum received-dosage of spinal cord were 37.45±2.39,39.38±2.78,40.13±2.52.There were statistical differences between Group A and B,Group A and C,Group B and C（P0.05）.Conclusion The plan of PET-CT positioned SMART of NSCLC can optimize target dose distribution,lessen effectively the doses and volume of circumferential normal tissues.

关 键 词：非小细胞肺癌 调强放射治疗 同步加量调强放射治疗 三维适形放射治疗 PET-CT 

分 类 号：R734.2[医药卫生—肿瘤]