不同体质量指数食管癌患者放疗中的摆位误差  

Comparison of patient positioning errors in esophageal cancer patients with different body mass indexes undergoing radiation therapy

作　　者：于松茂 陈吉祥[1] 康加阜 杨敬贤[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国肿瘤临床与康复》2017年第8期939-942,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨不同体质量指数食管癌患者放疗中的摆位误差。方法选取2012年6月至2016年2月间北京大学肿瘤医院暨北京市肿瘤防治研究所收治的88例行调强放疗的食管癌患者,根据体质量指数不同分为观察组(BMI≥25kg/m^2)28例与对照组(BMI<25kg/m^2)60例,两组患者均给予影像系统测量X轴、Y轴及Z轴的摆位误差,比较两组患者肿瘤控制概率和周围组织发生并发症概率,进行靶区剂量学分析。结果观察组患者X、Y和Z轴方向的摆位误差分别为(8.83±3.10)mm、(5.45±3.12)mm和(6.24±3.13)mm,均高于对照组患者的(2.41±1.93)mm、(2.11±1.33)mm和(1.98±1.56)mm,差异均有统计学意义(均P<0.05)。观察组患者的局部控制概率(TCP)、脊髓正常组织并发症概率(NTCP)与肺NTCP分别为(18.44±3.10)%、(4.87±1.09)%和(9.82±1.45)%,对照组患者分别为(18.56±4.19)%、(3.20±1.40)%和(8.08±1.66)%,观察组患者脊髓NTCP与肺NTCP均明显高于对照组,差异均有统计学意义(均P<0.05)。观察组患者计划靶区(PTV)-大体肿瘤体积(gtv)的最低剂量(Dmin)、平均剂量(Dmean)与95%体积的最低照射剂量(D95)比较,差异均无统计学意义(均P<0.05)。结论体质量指数≥25kg/m^2的食管癌患者,在放疗中会增加各个方向的摆位误差,加大脊髓与肺部正常组织并发症发生概率。Objective To explore and compare patient positioning errors in esophageal cancer pa- tients with different body mass indexes （BMI） undergoing radiation therapy. Methods From June 2012 to February 2016, 88 esophageal cancer patients undergoing intensity modulated radiation therapy （IMRT） at Key Laboratory of Carcinogenesis and Translational Research （ Ministry of Education）, Peking University Cancer Hospital ＆ Beijing Office for Cancer Prevention and Control were selected as the research subjects. According to BMI, patients were divided into an observation group （BMI 〉25kg/m2, 28 patients） and a control group （BMI 〈25kg/m2, 60 patients）. Both groups were given imaging system detection to measure positioning errors of X, Y and Z axis. tumor control probability and complication probability in peripheral tissues were compared between the two groups. Simultaneously, a dosimetric analysis was conducted. Results Positioning errors for X, Y and Z axis were （8.83 ± 3.10 ） mm, （5.45 ± 3. 12） mm and （6. 24 ± 3.13） mm, respectively for the observation group, which were higher than （ 2.41 ± 1.93 ） mm, （2. 11 ± 1.33） mm and （ 1.98 ± 1.56） mm of the control group, respectively （ P 〈 0. 05 ）. Tumor controlprobability （TCP）, spinal cord normal tissue complication probability （NTCP） and pulmonary NTCP was （ 18.44 ± 3. 10） %, （4. 87 ± 1.09 ） % and （ 9. 82 ± 1.45 ） %, respectively for the observation group and （ 18. 56 ± 4. 19） % , （ 3.20 ± 1.40 ） % and （ 8.08 ± 1.66 ） % , respectively for the control group. Spinal cord NTCP and pulmonary NTCP in the observation group was significantly higher than in the control group （ P 〈 0. 05 ）. There was no significant difference in planning target volume （ PTV）, the lowest dose of the gross target volume （GTV） （Dmin） and mean dose （Dmean） and dose covering 95% of the volume （D95） between the two groups （ P 〈 0. 05 ）. Conclusion Positioning errors in all directions

关 键 词：体质量指数 食管肿瘤 调强放疗 摆位误差 肿瘤控制概率 

分 类 号：R730.55[医药卫生—肿瘤] R735.1[医药卫生—临床医学]