肿瘤靶区与全肺的体积比对食管癌调强放疗肺剂量体积参数的影响  

Effect of Tumor to Lung Volume Ratio on Pulmonary Dose-volume Parameters of IMRT for Esophageal Cancer

作　　者：郭飞宝[1] GUO Fei-bao(Department of Radiotherapy,First Affiliated Hospital of Fujian Medical University,Fujian Fuzhou 350005)

机构地区：[1]福建医科大学附属第一医院放疗科,福建福州350005

出　　处：《中国医疗器械信息》2020年第24期1-3,43,共4页China Medical Device Information

基　　金：福建省高校产学合作项目(项目名称:基于机器学习的鼻咽癌放射治疗靶区自动勾画和治疗计划预评价研究与应用;项目编号:2019Y4005)。

摘　　要：目的:探索肿瘤靶区与全肺体积比对食管癌调强放疗肺剂量体积参数的影响。方法:回顾性分析2010年11月~2019年8月在本院行调强放疗的89例食管癌病例。其中PTV-G为肿瘤区外扩计划靶区,PTV-C为临床靶区外扩计划靶区。1.分析KG(PTV-G与全肺体积比)和KC(PTV-C与全肺体积比)的相关性;2.对KC与全肺V5、V10、V20和V30进行曲线拟合分析。结果:①KG与KC具有强相关性;②随KC增大,全肺V5、V10和V20先呈二次曲线性增大,达到临界值后开始下降(R^2分别为0.321、0.347和0.333),全肺V30近似呈线性增大(R^2为0.453)。结论:食管癌调强放疗中若KC超过一定临界值(0.15),应更多关注V30的剂量体积限值,以期预防放射性肺炎的发生。Objective:To explore the effect of tumor to lung volume ratio on pulmonary dose-volume parameters by intensity modulated radiation therapy(IMRT)in patients with esophagus cancer(EPC).Methods:A total of 89 EPC cases underwent IMRT from November 2010 to August 2019 were retrospectively analyzed.Set PTV-G as the external expansion planning target volume(PTV)of the gross tumor volume(GTV)and PTV-C as the external expansion volume of the clinical target volume(CTV).1.Analyze the correlation between KG(PTV-G to lung volume ratio)and KC(PTV-C to lung volume ratio);2.Analyze the correlation between KC and V5,V10,V20 and V30 by curve fitting method.Results:①There was a strong correlation between KG and KC;②As the increase of KC,V5,V10,and V20 first increasein a quadratic curve,and then tend to decline(R^2 is 0.321,0.347,and 0.333),and V30 increases approximately linearly(R^2 is 0.453).Conclusion:If KC exceeds a certain critical value(about 0.15),more attention should be paid to the limit of V30 to prevent radiation pneumonitis.

关 键 词：食管癌 调强放疗 肿瘤体积 肺剂量体积参数 

分 类 号：R739.91[医药卫生—肿瘤]