56例NSCLC脑转移灶与海马距离及与海马保护状态下PCI的PTV低剂量区关系  

Distance between brain metastases of non-small cell lung cancer and the hippocampus and its correlation with PTV low-dose regions in prophylactic cranial irradiation with hippocampal avoidance： an analysis of 56 patients

作　　者：陈远[1] 顾文栋[1] 田野[2] 沐金明[1] 莫俊聪 裴红蕾[1] 

机构地区：[1]苏州大学附属第三医院常州市第一人民医院放疗科,常州213003 [2]苏州大学附属第二医院放疗科,215004

出　　处：《中华放射肿瘤学杂志》2016年第1期42-45,共4页Chinese Journal of Radiation Oncology

摘　　要：目的探讨NSCLC脑转移患者海马保护状态下PCI（HA-PCI）的可行性。方法搜集2011～2014年间56例NSCLC脑转移患者资料，在T1W1增强MRI上勾画脑转移病灶和海马，分析脑转移病灶与海马之间距离：并设计HA—PCI计划，分析病灶在海马周围PTV低剂量区域内的分布情况。结果139个病灶无一累及海马，海马外放5、10mm范围时分别有6个（4．3％）、18个（12．9％）病灶。HA-PCI计划PTV的D50%、D2%分别为25．6、27．1Gy；海马Dmean、D2%分别为7．4、9．9Cy；海马外围0～5．0、5．1～10．0、10．1～15．0mm区域D50%分别为10．3、15．1、20．5Gy。结论HA-PCI理论上是可行的，但还需长期生存患者颅内失败模式来证实。Objective To investigate the feasibility of prophylactic cranial irradiation with hippocampal avoidance （HA-PCI） in non-small cell lung cancer （NSCLC）. Methods The clinical data of 56 patients with brain metastases of NSCLC who were treated from 2011 to 2014 were collected. Brain metastases and the hippocampus were delineated on T1W1 contrast-enhanced MRI, and the distance between brain metastases and the hippocampus was analyzed; an HA-PCI regimen was also developed, and the distribution of the metastases in planning target volume （PTV） low-dose regions around the hippocampus was analyzed. Results None of the 139 metastases involved the hippocampus. There were 6 （4. 3%） and 18 （12. 9%） metastases within 5 mm and 10 ram, respectively, outside the hippoeampus. In the HA-PCI regimen, the D50% and D2% of PTV were 25.6 Gy and 27. 1 Gy, respectively. D and D2% for the hippoeampus were 7.4 Gy and 9. 9 Gy, respectively;D50% within 0-5.0 mm, 5.1-10. 0 mm, and 10. 1-15.0 mm outside the hippocampus was 10. 3 Gy, 15. 1 Gy, and 20. 5 Gy, respectively. Conclusions HA-PCI may be feasible theoretically, but this needs to be confirmed by the intracranial failure pattern in patients with long-term survival.

关 键 词：海马保护 全脑照射 非小细胞肺癌 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]