食管癌调强放疗靶区与肺体积比和处方剂量的关系  

The relationship of target area and lung volume ratio with prescription dose of IMRT for esophageal cancer

作　　者：孙建伟 王强[1] 梁冰花 韩超[1] 苗慧[1] 袁成[1] 惠华[1] 张涛[1] SUN Jianwei;WANG Qiang;LIANG Binghua;HAN Chao;MIAO Hui;YUAN Cheng;HUI Hua;ZHANG Tao(Department of radiotherapy,Xuzhou Cancer Hospital,Xuzhou 221000 China)

机构地区：[1]徐州市肿瘤医院放疗科,江苏徐州221000

出　　处：《中国辐射卫生》2021年第3期315-320,共6页Chinese Journal of Radiological Health

基　　金：江苏省青年医学重点人才资助项目(QNRC2016396);江苏省六大人才高峰资助项目(YY-156)。

摘　　要：目的研究食管癌调强放射治疗中能够做出既定目标的放疗计划时,靶区体积与肺体积比值和处方剂量的关系,从而帮助临床医生根据靶区情况,选择适合的处方剂量。方法随机选取临床上已进行放射治疗的食管癌患者80例;其中病变范围包括全部食管癌类型,靶区根据ICRU(International Commission Radiological Units)50、62号文件进行勾画;设定统计参数及计划目标。根据参数的统计结果进行统计学分析;通过拟合计算求出满足既定目标的体积比临界值。结果体积比与肺V_(5)、V_(20)、V_(30)以及肺平均受量具有线性正相关关系。给予60 Gy的处方剂量时,体积比的临界值为10%;给予50 Gy的处方剂量时,体积比的临界值为13%。结论根据研究结果可以预见:食管癌调强放疗中当靶区体积与肺体积比值超过10%时,考虑给予的处方剂量不高于60 Gy;当靶区体积与肺体积比值超过13%时,给予处方剂量时应谨慎选择,但对于各段食管癌靶区超出肺段的患者可适当放宽。这为临床医生勾画靶区期间在处方剂量和靶区范围的选择上提供了参照。Objective To study the relationship between the ratio of target volume to lung volume and the prescription dose in intensity modulated radiation therapy(IMRT)for esophageal cancer,so as to help clinicians to choose the appropriate prescription dose according to the target situation.Methods 80 patients with esophageal cancer were randomly selected.The lesion range included all types of esophageal cancer,and the target area was outlined according to ICRU(International Commission Radiological Units)50 and ICRU62.Set statistical parameters and plan objectives.Statistical analysis was performed according to the statistical results of the parameters.The critical value of volume ratio is obtained by fitting calculation.Results there was a positive linear correlation between volume ratio and lung V_(5),V_(20),V_(30) and average lung dose.The critical value of volume ratio is 10% for 60 Gy and 13%for 50 Gy.Conclusion according to the research results,it can be predicted that when the ratio of target volume to lung volume is more than 10%,the prescribed dose should not be higher than 60 Gy;when the ratio of target volume to lung volume is more than 13%,the prescribed dose should be selected cautiously,meanwhile in the condition of whose target volume exceeds lung segment the prescribed dose.This provides a reference for clinicians when choose the prescription dose and target range while making the target delineation.

关 键 词：食管肿瘤 靶区体积 肺体积 体积比 临界值 

分 类 号：R816[医药卫生—放射医学]