4D-CT与ABC技术在肺部放疗呼吸管理中的比较  

Comparison study on 4D-CT and ABC techniques in respiratory management during lung radiotherapy

作　　者：崔天祥[1] 徐燕梅[1] 周一兵[1] 周军[1] 孙建国[1] 

机构地区：[1]第三军医大学新桥医院全军肿瘤研究所,重庆400037

出　　处：《重庆医学》2013年第28期3337-3338,3341,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81272496);第三军医大学临床科研基金资助项目(2011D272)

摘　　要：目的评价四维CT(4D-CT)与主动呼吸控制技术(ABC)在肺部放疗呼吸管理中的异同,探讨不同患者采用不同呼吸控制技术的适应证和可行性。方法选取21例肺部肿瘤放疗患者进行呼吸运动管理,其中11例患者采用4D-CT技术,10例患者采用ABC技术。分别计算计划靶区体积(PGTV)与静态大体肿瘤体积(GTV)的比值(PGTV/GTV),比较两种呼吸管理技术在照射靶区、定位时间、计划时间、治疗时间上的差异,探讨不同患者采用不同呼吸控制技术的适应证。结果 4D-CT技术中PGTV/GTV比值为4.38±2.95,ABC技术中PGTV/GTV比值为2.21±0.69,二者比较差异有统计学意义(P<0.05);定位时间、照射时间4D-CT技术显著短于ABC技术(P<0.05),而计划时间比较差异无统计学意义(P>0.05)。使用ABC技术和4DCT技术的患者客观缓解率分别为50.0%、45.5%,放射性肺炎发生率分别为30.0%、27.3%,二者比较差异无统计学意义(P>0.05)。结论肺部放疗中,ABC技术照射体积小,适合体力状况较好患者;4D-CT技术省时、耐受性好,适合肿瘤体积较小患者。Objective To evaluate the similarities and differences between four-dimensional radiotherapy（4D-CT） and active breathing control techniques（ABC） in respiratory management in lung radiotherapy,and investigate the indications and feasibility of different breathing control techniques for different patients. Methods Twenty-one patients treated with lung radiotherapy received respiratory management. 4D-CT technology was used in 11 patients,while ABC technology was adopted in the rest 10. The ratios of planning target volume（PGTV） to gross tumor volume（GTV）[（PGTV/GTV）] were calculated. The differences between these two respiratory management technologies were compared in terms of the PGTV, positioning time, planning time and treatment time to investigate the indications. Results 4D-CT technology had higher PGTV/GTV ratio,and shorter positioning time and irradiation time than ABC technology（P〈0.05） ,but there was no significant difference in the planning time（P〉0.05）. In patients with ABC and 4D-CT technology, objective response rates were 50. 0%, 45. 5%, respectively, and the radiation pneumonitis rates were 30.0% ,27.3% ,respectively. There was no significant difference in both groups（P〉0.05）. Conclusion In lung tumor radiothera- py, ABC can reduce irradiation volume, suitable for patients with good performance status. 4D-CT is time-saving and well tolerated, suitable for patients with smaller tumors.

关 键 词：肺肿瘤 放射疗法 主动呼吸控制 四维放疗 计划靶区 

分 类 号：R734.2[医药卫生—肿瘤]