立体定向消融放疗肺部肿瘤体积变化趋势研究  

Time trend of tumor volume variation during stereotactic ablative radiotherapy for lung tumor

作　　者：孙亚楠 叶柯 葛红 王若峥[2] 郑瑞峰 

机构地区：[1]郑州大学附属肿瘤医院放疗科,郑州市450008 [2]新疆医科大学附属肿瘤医院放疗科 [3]河南武警总队医院

出　　处：《医药论坛杂志》2014年第8期1-3,共3页Journal of Medical Forum

基　　金：国家自然科学基金(81372436);河南省科技厅重点科技攻关(112102310006);新疆维吾尔自治区科技支疆项目(201291171);郑州市科技创新团队(121PCXTD524)

摘　　要：目的研究利用滑轨CT系统评估立体定向消融放疗过程中肺部肿瘤体积的变化趋势。方法从2011年10月至2014年5月,共有34例肺部肿瘤在CT-vision加速器接受SABR。治疗定位及摆位验证均采用自由呼吸下螺旋CT扫描。采用骨性配准将验证CT与定位CT融合并勾画每次治疗前的大体肿瘤体积(gross tumor volume,GTV),得出分次间肿瘤体积的变化趋势。结果广义估计方程结果示肺部肿瘤的体积随时间变化并无明显的缩小(P=0.078)。肿瘤体积变化的百分比在第2次放疗前增加了5%。治疗后GTV下降的百分比为12.8%,而GTV下降的绝对值为每个肿瘤平均1.53 cm3。结论尽管SABR治疗期间肿瘤体积有缩小趋势,但并无统计学意义,因而SABR治疗过程中可能不必进行缩野照射。Objective To determine the time trend of tumor volume variation during stereotactic body radiation therapy（SABR） for lung cancer using image- guided computed tomography（CT） on- rail system. Methods A total of 34 tumors were treated by SABR in 4 ～ 5 fractions using an integrated CT- LINAC system. The fast helical CT scans acquired for treatment setup were retrospectively registered with simulation CT scans on the basis of the bony reference region of interest（ROI）. Then,the gross target volume（GTV） was contoured on all verification CT scans and compared to the initial GTV in treatment plan. Interfractional variation of tumor volume regression variation was evaluated. Results GTVs did not decrease significantly along with the elapse of time from the beginning to the end of SABR treatment（P= 0. 078）. The mean GTVs increased by approximate 5% before the second fraction of SABR transiently. From then on,the decrease of GTV was consistent. Finally,the mean of percentile GTV reduction was 12. 8% and the mean absolute GTV reduction was 1. 53 cm^3. Conclusion Small but insignificant tumor volume regression was observed during lung SABR. It should be not necessary to perform another field shrink during SABR treatment.

关 键 词：肺部肿瘤 立体定向消融放疗 肿瘤体积变化 滑轨CT 

分 类 号：R734.2[医药卫生—肿瘤]