鼻咽癌螺旋断层调强放疗中优化MVCT扫描范围的可行性  

Feasibility on optimizing MVCT scan range in tomotherapy of nasopharyngeal carcinoma

作　　者：杨海松[1] 聂晓历[2] 刘利彬[1] 傅万凯[1] 黄星武[1] 邹钦凤[1] 柏朋刚[1] YANG Haisong;NIE Xiaoli;LIU Libin;FU Wankai;HUANG Xingwu;ZOU Qinfeng;BAI Penggang(Department of Radiotherapy,Fujian Provincial Cancer Hospital/Fujian Medical University Cancer Hospital,Fuzhou 350014,China;Department of Radiological Diagnosis,Fujian Provincial Cancer Hospital/Fujian Medical University Cancer Hospital,Fuzhou 350014,China)

机构地区：[1]福建省肿瘤医院/福建医科大学附属肿瘤医院放疗科,福建福州350014 [2]福建省肿瘤医院/福建医科大学附属肿瘤医院放诊科,福建福州350014

出　　处：《中国医学物理学杂志》2018年第8期874-878,共5页Chinese Journal of Medical Physics

基　　金：国家临床重点专科建设项目;福建省自然科学基金(2015Y0010);福建省临床重点专科建设项目

摘　　要：目的:探讨鼻咽癌螺旋断层调强放疗中两种应用兆伏级高能X线计算机体层摄影术(MVCT)扫描范围的引导方案的可行性。方法:选取行螺旋断层调强放疗的鼻咽癌患者20例,每例患者各扫描30次MVCT,15次扫描范围为鼻咽部靶区+颈部,15次为只有鼻咽部靶区,共获600组数据,两组进行配对t检验。结果:鼻咽部靶区+颈部的摆位误差结果在左右(X)、头脚(Y)、前后(Z)方向线性误差和绕此3个方向形成的旋转误差(U、V、W)分别为(-0.20±1.15)mm、(-0.01±1.60)mm、(0.02±0.83)mm、(-0.31±0.80)°、(0.27±0.80)°、(-0.06±0.58)°;鼻咽部靶区摆位误差结果分别为(-0.21±1.39)mm、(-0.13±1.85)mm、(-0.02±1.14)mm、(-0.05±0.89)°、(0.18±0.89)°、(-0.18±0.63)°。两组在上述6个方向上的比较,P值分别为0.92、0.19、0.59、0.00、0.11、0.02,结果显示X、Y、Z、V方向上P值大于0.05,无统计学意义;U、W方向上P值小于0.05,有统计学意义。结论:两种扫描范围在鼻咽癌螺旋断层调强放疗中线性误差无统计学意义,可以采用只扫描鼻咽部靶区的方式进行图像引导放疗,节约治疗时间和减少患者不必要的辐射。Objective To explore the application of two scan ranges of MV-computed tomography（MVCT） in tomotherapy of nasopharyngeal carcinoma（NPC）. Methods Twenty patients receiving tomotherapy for NPC were selected. Each patient was scanned by MVCT for 30 times, including 15 times of nasopharyngeal target area ＋ neck and 15 of only nasopharyngeal target area. A total of 600 groups of data were obtained, and paired t test was conducted on the two groups. Results For the scan range of nasopharyngeal target area＋neck, the linear errors in left-right（X）, head-foot（Y） and front-back（Z） directions were（-0.20±1.15）,（-0.01±1.60） and（0.02±0.83） mm, respectively, and the rotational errors that revolved around the 3 axes（U, V, W） were（-0.31±0.80）°,（0.27±0.80）° and（-0.06±0.58）°, respectively. For the scan range of only nasopharyngeal target area, the linear errors in X, Y and Z directions were（-0.21±1.39）,（-0.13±1.85） and（-0.02±1.14） mm, respectively, and the corresponding rotational errors were（-0.05±0.89）°,（0.18±0.89）°and（-0.18±0.63）°, respectively. The comparison of differences in set-up errors between the two groups showed that P values in 6 directions（X, Y, Z, U, V and W） were 0.92, 0.19, 0.59, 0.00, 0.18 and 0.02, respectively.The statistical differences were found in U and W directions（P〈0.05）, but not in the other directions（P〉0.05）. Conclusion The two MVCT scan ranges in tomotherapy of NPC don＇t show any statistical significance in linear errors. Therefore, the scan ranges of only nasopharyngeal target area can be applied for image-guided radiotherapy to shorten treatment time and reduce unnecessary radiation.

关 键 词：鼻咽癌 螺旋断层调强放疗 兆伏级高能X线计算机体层摄影术 扫描范围 摆位误差 

分 类 号：R739.62[医药卫生—肿瘤]