射波刀治疗周围型非小细胞肺癌中金标位移统计分析  

Statistical analysis of gold marker displacement of peripheral non-small cell lung cancer treated by Cyberknife system

作　　者：于旭耀 王煜雯 袁智勇 宋勇春 张华[3] 董洋 王平 YU Xu-yao;WANG Yu-wen;YUAN Zhi-yong;SONG Yong-chun;ZHANG Hua;DONG Yang;WANG Ping(Department of Radiotherapy,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China;Department of Radiotherapy,Tianjin Medical University Cancer Institute and Hospital Airport Hospital,Tianjin 300300,China;Department of Pulmonary Oncology,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放疗科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中心,天津300060 [2]天津医科大学肿瘤医院空港医院放疗科,天津300300 [3]天津医科大学肿瘤医院肺部肿瘤科,天津300060

出　　处：《医疗卫生装备》2020年第12期63-66,共4页Chinese Medical Equipment Journal

摘　　要：目的:回顾性分析周围型非小细胞肺癌在射波刀放疗过程中金标位移情况,为肺癌靶区范围的确定及治疗提供参考。方法:选取2017—2019年200例植入金标并进行呼吸运动(Sychony)追踪治疗的周围型非小细胞肺癌患者,按照肿瘤位置(上叶、中叶、下叶)及体积大小(<100 mL、100~200 mL、>200 mL)进行分类。提取患者治疗过程中金标位移数据,采用SPSS 19.0软件进行统计分析。结果:周围型非小细胞肺癌内金标在头脚(I/S)方向位移较大,且与左右(L/R)方向、前后(A/P)方向的位移具有统计学差异(P<0.05),而L/R方向和A/P方向之间没有统计学差异。金标位移与肿瘤位置密切相关,位于肺下叶的肿瘤内部金标的位移幅度约为位于肺上叶的肿瘤的2倍,位于肺下叶且体积<100 mL的肿瘤内部金标I/S方向位移最大,为(26.29±9.89)mm,是位于肺上叶且体积<100 mL的肿瘤内部金标位移幅度[(6.55±1.63)mm]的4倍左右。结论:在采用射波刀等立体定向放射治疗系统进行周围型非小细胞肺癌放疗时,应当充分考虑患者呼吸引起肿瘤I/S方向的位移对治疗精度的影响,尤其是对体积<100 mL以及位于肺下叶的肿瘤应适当扩大其在I/S方向上的放疗靶区范围。Objective To analyze retrospectively gold marker displacement of peripheral non-small cell lung cancer treated by Cyberknife system so as to provide reference for the determination of target area and treatment.Methods From 2017 to 2019 totally 200 peripheral non-small cell lung cancer patients with gold marker implantation were selected and categorized according to tumor location(upper,middle and lower lobes)and volume(<100 mL,100-200 mL,>200 mL),who were treated with gold marker implantation and respiratory exercise(Sychony).The gold marker displacement data were extracted from the patients during treatment and analyzed statistically using SPSS 19.0 software.Results The gold marker displacement of peripheral non-small cell lung cancer at the superior-inferior(I/S)direction gained significantly higher values than those at left-right(L/R)and anterior-posterior(A/P)directions(P<0.05),while there were no statistical differences between the latter two ones;the displacement of the gold marker was closely related to the tumor location.The tumors located in the lower lobe of the lung had the gold marker displacement appraximately twice that of tumors in the upper lobe of lung,and showed the largest displacement(26.29±9.89)mm in the I/S direction,which was 4 times greater than that of tumors located in the upper lobe of the lung with a volume<100 mL((6.55±1.63)mm).Conclusions When radiotherapy for peripheral non-small cell lung cancer is performed with stereotactic radiotherapy systems such as radiolucent knife,the impact of the tumor displacement at I/S direction caused by the patient's breathing on the treatment accuracy should be fully considered;for tumors with a volume less than 100 mL and located in the lower lobe of the lung,the target area of radiotherapy at I/S direction should be appropriately expanded.

关 键 词：射波刀 周围型肺癌 非小细胞肺癌 立体定向体部放疗 金标位移 

分 类 号：R734.2[医药卫生—肿瘤]