胸中段食管癌临床靶体积构建方法对计划靶体积影响研究  

Comparison of planning target volumes for middle esophageal cancer of clinical target volumes contoured by different methods

作　　者：邵倩[1] 李建彬[1] 尚东平[1] 王素贞[1] 王伟[1] 戚焕鹏[1] 

机构地区：[1]山东省肿瘤医院放疗科,山东济南250117

出　　处：《中华肿瘤防治杂志》2013年第22期1740-1743,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省科技发展计划(2011YD18082)

摘　　要：目的：比较胸中段食管癌临床靶区不同勾画方法对计划靶体积（planningtargetvolume，PTV）的影响。方法：选择胸中段食管癌患者15例。1）PTV-30法：在层厚3mm定位加强CT片上勾画食管病灶为大体肿瘤体积（grosstumorvolume，GTV），上下外放30mm，左右、前后均外放lOmm定为CTV-30，CTV-30均外放5mm为PTV-30。2）PTV-15法：沿着食管GTV上下方向继续勾画15mm为GTV-15，GTV-15上下外放15mm，其余外放10mm为CTV-15，CTV-15均外放5Film为PTv-15。3）PTV-6法：沿着食管GTV上下方向继续勾画24mln为GTV-24，GTV24上下外放6mm，其余外放10mm为CTV-6，CTV-6均外放5mm为PTV-6。4）PTV-0法：沿着食管GTV上下方向继续勾画30mm为GTV-30，GTV-30上下外放0mm、其余外放10mm为CTV-O，CTV-O均外放5mm为PTV-0。在治疗计划系统TPS中显示各PTv的体积，比较PTV-30、PTv-15、PTV-6和PTV-0的体积。结果：15例食管癌患者的GTV长度为3．O～14．7cm，平均（7．27±3．03）cm；GTV最大横径为3．O～6．8cm，平均（4．46±1．11）cm；GTV体积为13．71～161．20cm3，平均（55．16士43．23）cm3。PTV-30为（392．51土123．32）cm3，PTV-15为（366．07±112．78）cm3，PTV-6为（346．55±103．70）cm3，PTV-0为（342．36±108．65）cm3。PTV-30与PTV-15（t=0．895）、PTV-6（t=4．791）和PTV-0（t=6．267）比较差异有统计学意义，P值均〈0．001；PTV-15与PTV-6（t=4．318，P〈0．001）、PTV-0（t=5．097，P〈O．001）比较差异有统计学意义；PTV-6与PTV-0比较差异无统计学意义，t=0．895，P=0．386。除PTV-6与PTV-0比较差异无统计学意义，其余两两比较差异均有统计学意义，P≤0．001。结论：食管癌靶区不同的勾画方法对PTV有显著影响，建议采用PTV-6或PTV-0的方法勾画靶区。OBJECTIVE：To compare the planning target volumes for esophageal, cancer of gross tumor volumes con- toured by different methods. METHODS： Fifteen patients with middle thoracic esophageal cancer were selected. 1） PTV-30：The GTV（ gross tumor volume） of the esophageal lesions was contoured in the thick layer of 3 mm ehanced CT. The GTV was enlarged 30 mm in upper and lower derection,and other detections including left and right, anterior and posterior were enlarged 10 mm defined as CTV-30 （clinical target volume,CTV）. The CTV-30 was enlarged 5 mm in all derection defined as PTV-30 （planning target volume,PTV）. 2）PTV-15 ：To contour GTV continue along the esopha- geal in upper and lower detection 15mm for GTV-15. The GTV-15 was enlarged 15mm in upper and lower derection,and other derections were enlarged 10 mm defined as CTV-15. The CTV-15 was enlarged 5 mm in all derection defined as PTV-15. 3）PTV-6 ：To contour GTV continue along the esophageal in upper and lower detection 24 mm for GTV-24. The GTV-24 was enlarged 6 mm in upper and lower derection,and other derections were enlarged 10 mm defined as CTV-6. The CTV-6 was enlarged 5ram in all detection defined as PTV-6. 4）PTV-0：To contour GTV continue along the esopha- geal in upper and lower detection 30 mm for GTV-30. The GTV-30 was enlarged 0mm in upper and lower detection,and other detections were enlarged 10 mm defined as CTV-0. The CTV-0 was enlarged 5 mm in all derection defined as PTV-0. PTV-30,PTV-15,PTV-6 and PTV-0 volume were compared. RESULTS： The length of GTV was from 3.0 cm to 14.7 cmand the mean length of GTVwas （7.27±3.03） cm. The diameter of GTVwas from 3.0 cm to 6.8 cm and the mean diameter of GTV was （4.46±1.11） cm. The volume of GTV was from 13.71 cma to 161.20 cm3 and the mean volume of GTV was （55.16±43.23） cm3. The PTV-30 ,PTV-15, PTV-6 and PTV-0 volume respectively were （392.51± 123.32） cm3 ,（366.07±112.78） cma ,（346.55±103.70） cm3 and （342.36±108.65） cma. The values of t were

关 键 词：食管肿瘤 放射疗法 肿瘤靶区 临床靶区 计划靶区 

分 类 号：R735.1[医药卫生—肿瘤]