主动呼吸控制在肺部肿瘤放射治疗中的临床应用价值  

The clinical application value of active breathing control in radiotherapy of lung cancer

作　　者：王峻峰[1] 黄章玲 李定宇[1] 刘飞[1] 彭慧[1] 胡国清[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤中心,430030

出　　处：《放射学实践》2016年第9期878-880,共3页Radiologic Practice

摘　　要：目的:探讨自由呼吸(FB)与主动呼吸控制(ABC)时肺部肿瘤靶区在单排螺旋CT慢速扫描中的成像规律,比较两种状态下肿瘤靶区在放射治疗中肺部吸收剂量的差异。方法:搜集非小细胞肺癌患者13例,采用单排螺旋CT慢速扫描分别在自由呼吸、主动呼吸控制下采集CT图像,勾画出两种呼吸状态下的大体肿瘤靶区(GTV),在GTV基础上外扩计划靶区(PTV),对比两种状态下计划靶区位置及形态的差异。针对13例患者制订放疗计划,计算双肺的V5(吸收剂量大于500cGY的肺百分体积)、V20(吸收剂量大于2000cGY的肺百分体积)及肺平均剂量(MLD)。对比ABC与FB两种状态下的剂量学差异。结果:ABC和FB状态下肿瘤PTV平均体积分别为(29.9±12.9)cm3和(81.2±35.4)cm3,差异有统计学意义(P<0.05)。ABC和FB两种状态下对应的V5分别为(14.2±4.7)%与(21.6±6.1)%,V20分别为(7.3±3.2)%与(11.9±3.8)%,MLD分别为(564.2±175.8)cGy与(753.9±211.2)cGy,差异均具有统计学意义(P<0.05)。结论:单排螺旋CT慢速扫描情况下,ABC与FB两种状态下肿瘤靶区的体积差异明显。呼吸控制可以有效减小靶区的体积,减轻肺部的副损伤,使进一步提高肿瘤的照射剂量成为可能。Objects：To investigate the image manifestations of target area of lung cancer using single slice CT with slow scanning mode under the condition of active breath control （ABC） and free breath （FB）. To compare the difference of dosage in radiotherapy of lung cancer between these two conditions. Methods： 13 patients with NSCLC were recruited. Single slice spiral CT with slow scanning mode under the condition of ABC and FB were used for image acquisition respectively. The gross tumor volume （GTV） of tumor target area under these two breath conditions were delineated. Then, to expand the GTV target area to obtain the planning target volume （PTV）. The differences of location and shape of these planned target areas under the two different cdnditions were compared. Radiotherapy plan was made for these 13 patients,the V5 the absorped dose 〉500Gy of lung volume % ,V20 absorped dose 〉2000Gy of lung volume % and MLD （mean lung dose） were calculated,the dose difference between ABC and FB was compared. Results：The mean volume of the tumor target area under ABC and FB were （29. 9 ±12, 9） cm and （81. 2 ± 35. 4） cm respectively, with significant statistic difference （P〈 0.05）. The corresponding V5 ,V20 and MLD of ABC and FB were （14.2±4.7） and （21.6±6.1） ;（7.2±3.2） and （11.9±3.8） ; （564.2 ± 175.8） cGy and （753.9 ±211.2） cGy, respectively, with significant differences （P〈0.05）. Conclusions ： The difference between the tumor target area under ABC and FB conditions was significant. Under single slice spiral CT with slow scanning mode, the volume of target area and the injury of lung could be effectively reduced and alleviated by breath control, which makes it possible to increase the radiation dose of tumor.

关 键 词：呼吸控制 放射治疗 体层摄影术 X线计算机 癌 非小细胞肺 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]