直肠癌术前／术后适形／调强放疗靶区勾画共识与图谱  

Consensus and contouring atlas for the delineation of clinical target volume in pre-/post-operative image.guided intensity modulated radiotherapy for rectal cancer

作　　者：无 唐源 金晶 朱远[7] 刘士新[8] 袁响林[9] 王文玲[10] 王小虎 章真 田野[13] 高远红[14] 张红雁[15] 蔡勇[16] 依荷芭丽·迟 蒋力明 刘正 文碧秀[17] 张大昕[18] 于大海[19] 吴君心[20] 林少民[21] 石梅[22] 李晔雄 Professional Committee of Radiotherapy for Colorectal Cancer of Chinese Medical Doctor Association; China Society for Radiation Oncology of Chinese Medical Association, Tang Yuan , Jin Jing , Zhu Yuan , Liu Shixin , Yuan Xianglin , Wang Wenling , Wang Xiaohuo , Zhang Zhen , Tian Ye, Gao Yuanhong , Zhang Hongyan , Cai Yong , Chi Yihebali , Jiang Liming , Liu Zheng , Wen Bixiu , Zhang Daxin , Yu Dahai , Wu Junxin , Lin Shaomin , Shi Mei , Li Yexiong(Department of Radiation Oncology , Department of Oncology Internal Medicine , Department of Imaging Diagnostics , Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China; Department of Radiation Oncology, Zhejiang Cancer Hospital ; Department of Radiation Oncology, Jilin Cancer Hospital ; Department of Oncology, Tong]i Hospital, Tongji Medical College of Huazhong University of Science and Technology; Department of Radiation Oncology , Guizhou Cancer Hospital ; Department of Radiation Oncology , Cancer Hospital, Fudan University ;Department of Radiation Oncology , Gansu Provincial Cancer Hospital;Department of Radiation Oncology , Second Affiliated Hospital of Soochow University ; Department of Radiation Oncology, Sun Yat-sen University Cancer Center ;Department of Radiation Oncology ,Anhui Provincial Hospital ; Department of Radiation Oncology, Beijing University Cancer Hospital ; Department of Radiation Oncology, First Affiliated Hospital, Sun Yat-sen University; Department of Radiation Oncology, First Affiliated Hospital ,Haerbin Medical University ;Department of Radiation Oncology , Jiangsu Province Hospital of TCM; Department of Radiation Oncology , Fujiang Province Cancer Hospital ; Department of Radiation Oncology , Hainan People＇ s Hospital ; Department of Radiation Oncology, Xifing Hospital, Fourth Military Medical Universit)

机构地区：[1]中国医师协会结直肠肿瘤专委会放疗专委会 [2]中华医学会放射肿瘤治疗学分会 [3]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021 [4]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [5]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021 [6]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021 [7]浙江省肿瘤医院放疗科 [8]吉林省肿瘤医院放疗科 [9]华中科技大学同济医学院同济医院肿瘤科 [10]贵州省肿瘤医院放疗科 [11]不详 [12]复旦大学附属肿瘤医院放疗科 [13]苏州大学附属第二医院放疗科 [14]中山大学肿瘤防治中心放疗科 [15]安徽省立医院放疗科 [16]北京大学肿瘤医院放疗科 [17]中山大学附属第一医院放疗科 [18]哈尔滨医科大学附属第一医院放疗科 [19]江苏省中医院放疗科 [20]福建省肿瘤医院放疗科 [21]海南省人民医院放疗科 [22]第四军医大学西京医院放疗科

出　　处：《中华放射肿瘤学杂志》2018年第3期227-234,共8页Chinese Journal of Radiation Oncology

基　　金：国家自然科学基金面上项目（81773241）;中国医学科学院医学与健康科技创新工程项目（2017-12M-1-006）

摘　　要：目的在三维放疗时代，为直肠癌术前／术后放疗制定靶区勾画的中国专家共识，并辅以高分辨率图谱。方法收集直肠癌放疗靶区勾画的国际指南，结合国内肿瘤中心的经验，起草“直肠癌术前／术后适形调强放疗靶区勾画共识与图谱”。在“中国医师协会结直肠肿瘤专委会放疗专委会”集中会议上进行讨论及投票，由专门的执行小组对最终的结果进行归纳。结果主要针对直肠癌放疗的定位技术、术前放疗靶区定义、根治术后放疗靶区定义、OAR定义、剂量和分割等方面，根据证据的强弱和专家意见一致的程度，给予分级推荐；同时在高分辨率CT上提供了CTV的图示。结论为直肠癌放疗提供中国专家共识，规范直肠癌放疗流程，减少不同单位或不同医生之间勾画的差异。Objective To establish a Chinese experts＇ consensus for the delineation of clinical target volume （CTV） of pre-/post-operative radiotherapy for rectal cancer in the era of three dimensional conformal radiotherapy, and compile a high-resolution contouring atlas. Methods The consensus and contouring atlas for the delineation of CTV of pre-/post-operative radiotherapy for rectal cancer were drafted by referring to international guidelines and treatment experience of domestic radiation centers. The details of draft were discussed and voted on the annual conference of Professional Committee of Radiotherapy for Colorectal Cancer of Chinese Medical Doctor Association. The final consensus was summarized by the steering committee. Results Based on the strength of the evidence and the consistency of experts＇ consensus, the grading recommendations for positioning technology, pre-/post-operative radiotherapy target definition, definition of organs at risk （OAR） , radiotherapy dose and fraction were delivered. In addition, the atlas of CTV was demonstrated on high-resolution on CT scan images. Conclusions To establish a Chinese experts＇ consensus for radiotherapy of rectal cancer, standardize the radiotherapy process and reduce the variance in the delineation of CTV among different hospitals and radiologists.

关 键 词：直肠肿瘤/放射疗法 靶区勾画 三维放疗技术 

分 类 号：R734.2[医药卫生—肿瘤]