X射线模拟机和射波刀同步呼吸追踪下肺肿瘤的运动规律分析  

Analysis on the motion law of lower lung tumor of X-ray simulator and synchronous breathing tracking by Cyberknife

作　　者：朱六玲 蔡陈枫 孟岩 ZHU Liu-ling;CAI Chen-feng;MENG Yan(Center of Radiotherapy,Shanghai Eastern Hepatobiliary Surgery Hospital,Shanghai 201805,China.)

机构地区：[1]上海东方肝胆外科医院放疗中心,上海201805

出　　处：《中国医学装备》2018年第12期53-56,共4页China Medical Equipment

摘　　要：目的:探讨X射线模拟机和射波刀立体定向放射治疗同步呼吸模型中左右下肺肿瘤的运动幅度及相关性,为射波刀立体定向放射治疗提供参考。方法:选取57例射波刀治疗的原发或转移下肺肿瘤患者,在CT引导下将纯金标记(金标)置入肿瘤体内或邻近位置,于X射线模拟定位机下测量左右下肺金标(肿瘤)左右(X轴)、胸前背后(Y轴)及头脚(Z轴)方向的运动幅度。通过建立同步呼吸模型,测量左右下肺肿瘤金标的3个方向运动幅度,并进行统计比较。结果:X射线模拟定位机下测量左下肺金标(肿瘤)X轴、Y轴和Z轴的运动幅度分别为(0.339±0.166)cm、(0.491±0.202)cm和(1.467±0.421)cm;右下肺分别为(0.317±0.100)cm、(0.412±0.145)cm和(1.483±0.565)cm。在射波刀立体定向放射治疗过程中,通过建立同步呼吸模型,测量金标(肿瘤)的左下肺肿瘤3个方向上的运动幅度分别为(0.388±0.150)cm、(0.509±0.211)cm和(1.468±0.415)cm;右下肺肿瘤分别为(0.379±0.977)cm、(0.446±0.150)cm和(1.500±0.550)cm。X射线模拟机下与射波刀同步呼吸模型左下肺肿瘤运动幅度在X轴和Y轴上的差异有统计学意义(t=2.965,t=-1.139;P<0.05),右下肺肿瘤运动幅度在X轴和Y轴上的差异有统计学意义(t=-3.021,t=2.563;P<0.05);左右肺在Z轴上差异无统计学意义(t=0.239,t=1.282;P>0.05)。结论:虽然配对样本t检验X轴和Y轴上有统计学差异,但均值差别<1 mm,在Z轴上无统计学差别。X射线模拟定位机下测量的左右肺金标(肿瘤)运动幅度与同步呼吸模型中测量金标(肿瘤)左右肺运动幅度大小基本一致。Objective:To investigate motion amplitude and correlation of left and right lower lung tumors under X-ray simulator and in synchronous breathing model of stereotactic radiotherapy of CyberKnife so as to provide reference for stereotactic radiation treatment of CyberKnife.Methods:57 patients with primary or metastatic lung tumors who once were treated by CyberKnife were selected.And gold Fiducials were inserted into the tumor body or adjacent position under CT guidance.X-ray simulator was used to measure motion amplitude of left and right lower lung Fiducials,with left and right(X axis),front and back of breast(Y axis),head and foot direction(Z axis).Through established synchronous breathing model,movement amplitudes of left and right lower lung gold Fiducials(tumors)in three directions were measured,and these data were compared statistically.Results:Motion amplitudes of X-axis,Y-axis and Z-axis of left lower lung gold Fiducials(tumor)were measured by X-ray simulator,and the results of them were(0.339±0.166)cm,(0.491±0.202)cm and(1.467±0.421)cm,respectively.And ones of right lower lung were(0.317±0.100)cm,(0.412±0.145)cm and(1.483±0.565)cm,respectively.In course of CyberKnife stereotactic radiotherapy,through established synchronous breathing model,the measured motion amplitudes of left lower lung gold Fiducials(tumors)in three directions were(0.388±0.150)cm,(0.509±.211)cm and(1.468±0.415)cm,respectively.And their right lower lung tumors were(0.379±0.977)cm,(0.446±0.150)cm and(1.500±0.550)cm,respectively.The differences of motion amplitude of left lower lung tumor at X-axis and Y-axis between X-ray simulator and synchronous breathing model of Cyberknife were significant(t=2.965,t=-1.139,P<0.05),respectively.And the differences of right lower lung tumor of them also were significant(t=-3.021,t=2.563,P<0.05),respectively.The differences of Z-axis between left lung and right lung were no significant(t=0.239,t=1.282,P>0.05).Conclusion:Although there are statistical difference in paired samples t-test betwe

关 键 词：模拟机 射波刀 肺癌 同步呼吸模型 运动幅度 

分 类 号：R734.2[医药卫生—肿瘤]