食管癌放射治疗CT模拟定位  

CT simulation in radiotherapy for esophageal carcinoma

作　　者：邓兰[1] 马春曦[1] 彭国林[1] 杨尚凌[1] 方心华[1] 宋建文[1] 刘志鸿[1] 

机构地区：[1]解放军184医院肿瘤科,江西鹰潭335000

出　　处：《东南国防医药》2013年第3期244-245,共2页Military Medical Journal of Southeast China

摘　　要：目的探讨CT模拟定位在食管癌放射治疗的临床应用价值。方法对行放疗的食管癌46例,比较CT模拟定位和常规模拟定位的剂量分布情况。结果食管钡剂造影不能显示肿瘤外侵情况,而以CT图像所示的肿瘤外侵率达80.43%,非对称性外侵达78.26%,淋巴结转移率达28.26%;CT扫描病变长度长于食管钡剂造影片所示病变长度,但两者比较无显著性差异(P>0.05);以实体肿瘤为中心设置照射野的90.00%等剂量线分布能100.00%包全肿瘤病灶,而食管腔为中心位置的常规模拟定位放射治疗计划中,90.00%等剂量线包全肿瘤病灶仅41.30%(P<0.05)。结论 CT模拟定位的放射治疗计划使食管癌放疗照射野的设置更加精确合理,但在应用CT勾画食管癌肿瘤靶区长度时,应参考X线钡餐检查。Objective To evaluate method of CT simulation in the treatment planning setup of esophageal carcinoma. Methods Forty-six patients with esophageal carcinoma were underwent both CT simulation and conventional simulation, dose distribution in the treatment planning setup was compared. Results Esophageal barium could not display the tumor invasion,but based on CT image,tumor invasion rate was 80.43%. 78.26% of the tumor was asymmetrical and lymph node metastasis rate was 28.26%. The lesion extent in CT scanning was longer than that in X-ray double-contrast imaging, but there was no significant difference between two groups （ P 〉 0.05 ）. When taking the tumor as the portal center,the whole lesion of all patients was totally covered by the 90% isodose curve. When the esoph- ageal lumen was taken as portal center, the 90% isodose curve in 41.30% of patients was able to cover the whole lesion（ P 〈 0.05 ）. Con- clusion CT simulation in the treatment planning setup of esophageal carcinoma is accurate and reasonable. X-ray barium meal and oth- er examinations should be referred when using CT to delineate tumor target volume of esophageal carcinoma for radiotherapy.

关 键 词：食管癌 CT模拟定位 常规模拟定位 放射治疗 

分 类 号：R735.1[医药卫生—肿瘤]