影像引导放疗在食管癌中的应用  

Application of Image-Guided Radiotherapy for Esophageal Cancer

作　　者：魏胜涛 李定杰[2] 王祥[2] 张海三[1] WEI Sheng-tao;LI Ding-jie;WANG Xiang;ZHANG Hai-san(Xinxiang Key Laboratory of Multimodal Brain Imaging,the Second Affiliated Hospital of Xinxiang Medical College,Xinxiang 453002,China;Department of Radiotherapy,Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]新乡医学院第二附属医院新乡市多模态脑影像重点实验室,河南新乡453002 [2]河南省肿瘤医院放疗科,河南郑州450008

出　　处：《河南医学研究》2020年第11期1957-1960,共4页Henan Medical Research

摘　　要：目的分析食管癌放疗患者各段脊髓在影像引导前后位置偏差,探讨脊髓分段外放的必要性。方法选取2017年1月至2019年12月于河南省肿瘤医院确诊为食管癌并接受放疗的60例患者,分为颈段组、胸段组、腹段组,每组20例。颈胸膜或真空袋固定,采用调强放疗技术,ONCOR Impression加速器治疗患者,每例收集连续20次治疗影像,每次治疗前后均获取验证CT图像,与定位CT进行配准,获取分次间和分次内的位置偏差值。采用配伍方差分析比较各段脊髓位置偏差值是否有统计学意义,并计算影像校正前后的摆位外扩值。结果影像引导校正前颈、胸、腹段脊髓X摆位外扩值分别为3.44、5.09、6.12 mm,Y摆位外扩值分别为3.45、3.42、4.16 mm,Z摆位外扩值分别为3.66、4.51、6.84 mm;影像引导校正后颈、胸、腹段脊髓X摆位外扩分别为1.87、1.33、2.24 mm,Y摆位外扩值分别为1.89、1.35、1.30 mm,Z摆位外扩值分别为1.71、1.37、2.24 mm。结论食管癌患者影像引导校正前后脊髓各段摆位误差不同,应采用不同外扩值。Objective To analyze the position deviation of different segments of spinal cord before and after image guidance in patients with esophageal cancer radiotherapy,and to discuss the necessity of segmenting spinal cord extraversion.Methods A total of 60 patients who were diagnosed with esophageal cancer and received radiotherapy in Henan Cancer Hospital from January 2017 to December 2019 were selected and divided into cervical group,thoracic group and abdominal group,with 20 patients in each group.Cervical pleura or vacuum bag was fixed.Patients were treated with intensity modulated radiotherapy technology and ONCOR Impression accelerator.Images were collected for 20 consecutive times for each patient.Before and after each treatment,CT images were obtained for verification,CT positioning was performed for registration,and position deviation values between and within each treatment were obtained.Compatibility analysis of variance was used to compare the position deviation of each segment of spinal cord.The out-of-position expansion before and after image correction was calculated.Results Before image correction,the positions of X of cervical,thoracic and abdominal spinal cord were 3.44,5.09 and 6.12 mm,respectively.The positions of Y of cervical,thoracic and abdominal spinal cord were 3.45,3.42 and 4.16 mm,respectively.The positions of Z of cervical,thoracic and abdominal spinal cord were 3.66,4.51 and 6.84 mm,respectively.After image correction,the positions of X of cervical,thoracic and abdominal spinal cord were 1.87,1.33 and 2.24 mm,respectively.The positions of Y of cervical,thoracic and abdominal spinal cord were 1.89,1.35 and 1.30 mm,respectively.The positions of Z of cervical,thoracic and abdominal spinal cord were 1.71,1.37 and 2.24 mm,respectively.Conclusion Positioning errors of every spinal cord segment before and after image guided correction in patients with esophageal cancer are different,and different extranodation values should be given.

关 键 词：食管癌 影像引导放疗 摆位误差 脊髓 

分 类 号：R735.1[医药卫生—肿瘤]