三种方法确定食管癌GTV长度的比较研究  

Comparative study of three different methods in the determination of length of gross target volumefor esophageal cancer radiotherapy

作　　者：海平 赵仁 杨小荣 王艳阳 潘闻燕 王嘉琳 拜周兰 陆海洋 Department of Radiation Oncology(Hai P, Zhao R, Wang YY, Pan WY, Wang JL, Bai ZL, Lu HY ） , Department of Gastroenterology （ Yang XR ） , Tumor Hospital and General Hospital of Ningxia Medical University, Yinchuan 750004, Chin)

机构地区：[1]宁夏医科大学总医院肿瘤医院放疗科,银川750004 [2]宁夏医科大学总医院肿瘤医院消化内科,银川750004

出　　处：《中华放射肿瘤学杂志》2018年第4期370-373,共4页Chinese Journal of Radiation Oncology

基　　金：宁夏回族自治区科技支撑计划项目（2012）

摘　　要：目的 与胸部CT相比,超声胃镜可以更准确的确定食管癌病灶的上、下界,对超声胃镜确定的上、下界用钛夹标记有助于食管癌放疗靶区勾画。比较食管钡餐造影、胸部CT和超声胃镜下钛夹标记法在确定食管癌放疗GTV长度中的作用,为合理确定食管癌放疗GTV提供依据。采用成组t检验差异。方法 选择组织学或细胞学诊断明确、拟行放疗的胸段食管癌初治患者30例进入研究。每例患者均在治疗前行食管钡餐造影、胸部CT和超声胃镜下钛夹置入后CT模拟定位。比较食管钡餐造影、胸部CT和超声胃镜下钛夹法确定食管癌放疗GTV的长度。结果 食管钡餐造影、胸部CT、超声胃镜下钛夹标记法确定食管癌GTV长度分别为（6.1±1.4）、（6.8±1.9）、（6.3±1.9） cm。与胸部CT确定的GTV长度相比,超声胃镜下钛夹标记法确定食管癌GTV长度与之相仿（P=0.11）。食管钡餐造影确定食管癌GTV长度小于胸部CT确定的GTV长度（P=0.03）。全组患者中超声胃镜下钛夹标记法确定的GTV长度大于胸部CT确定GTV长度的比例为22.2%;超声胃镜下钛夹标记法确定GTV长度与胸部CT确定GTV长度相同的比例为11.1%;超声胃镜下钛夹标记法确定GTV的长度小于胸部CT确定GTV长度的比例为66.7%。结论 超声胃镜下钛夹标记法确定食管癌GTV长度较食管钡餐造影和胸部CT均有一定差异,可成为确定食管癌放疗GTV长度的有效方法之一。Objective Compared with chest CT, endoscopic ultrasonography （EUS） can more accurately determine the upper and lower margins of esophageal cancer, and marking the upper and lower margins of the esophageal cancer with titanium clip contributes to the delineation of target area of esophageal cancer during radiotherapy. To compare the effects of esophageal X-ray, chest computed tomography （CT） scan and EUS-assisted placement of marker clip in the determination of the length of gross target volume （GTV）, aiming to provide reference for the determination of GTV during esophageal cancer radiotherapy. Methods Thirty patients who were initially diagnosed with thoracic esophageal cancer by histological and cytological examinations and scheduled to receive radiotherapy were recruited in this investigation. All patients received esophageal X-ray, CT scan, and EUS-assisted placement of marker clip. The length of GTV was quantitatively measured and statistically compared among three different Methods. Results The length of GTV was （6.1±1.4） cm,（6.8±1.9） cm and （6.3±1.9） cm determined by esophageal X-ray,CT scan and EUS-assisted placement of marker clip,respectively. Compared with CT scan,the length of GTV determined by EUS-assisted placement of marker clip did not significantly differ （P=0.11）.The length of GTV determined by esophageal X-ray was significantly shorter than that by CT scan （P=0.03）. Among all patients, the length of GTV determined by EUS-assisted placement of marker clip was longer compared with that by chest CT scan in 22.2% of patients. The length of GTV determined by EUS-assisted placement of marker clip was the same as that by chest CT scan in 11.1% of patients. The length of GTV determined by EUS-assisted placement of marker clip was shorter compared with that by chest CT scan in 66.7% of patients. Conclusions EUS-assisted placement of marker clip differs from esophageal X-ray and CT scan in determining the length of GTV,which acts as one of the effective Methods in the d

关 键 词：食管肿瘤/放射疗法 大体肿瘤体积:超声胃镜 

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