基于亚肝段功能单元保护的优化放疗在肝癌精准放疗中的应用研究  

Application of optimized radiotherapy based on hepatic subsegmental function reserve in precision radiotherapy for liver cancer

作　　者：高宗毅[1] 苗成龙[1] 赵红[1] 贾彦丽[2] 贾立娟[2] 杨书峥[3] GAO Zongyi;MIAO Chenglong;ZHAO Hong;JIA Yanli;JIA Lijuan;YANG Shuzheng(Department of Radiotherapy,Binzhou Central Hospital,Shandong,Binzhou 251700,China;Department of Oncology,Binzhou Central Hospital,Shandong,Binzhou 251700,China;Department of Radiology,Binzhou Central Hospital,Shandong,Binzhou 251700,China)

机构地区：[1]山东省滨州市中心医院放疗科,山东滨州251700 [2]山东省滨州市中心医院肿瘤科,山东滨州251700 [3]山东省滨州市中心医院放射科,山东滨州251700

出　　处：《中国医药科学》2022年第4期165-168,共4页China Medicine And Pharmacy

基　　金：山东省滨州医学院附属医院科研计划项目(BY2019KJ83)。

摘　　要：目的探究基于亚肝段功能单元保护的优化放疗在肝癌精准放疗中的应用效果。方法选取2018年1月至2020年12月滨州市中心医院放疗科治疗的60例原发性肝癌患者,按照随机数字表法分为观察组和对照组,每组各30例。对照组实施三维适形放射治疗(3D-CRT),观察组实施基于亚肝段功能单元保护的优化放疗。比较两组靶区体积(GTV),99%的计划靶区体积(PTV)累积受照剂量、正常肝组织受照剂量(MDTNL)、正常组织并发症概率(NTCP)及放射性肝损伤(RILD)发生率。结果两组患者GTV及MDTNL比较,差异无统计学意义(P>0.05),但观察组患者PTV(D99)累积受照剂量明显高于对照组,差异有统计学意义(P<0.05);观察组NTCP及RILD发生率低于对照组,差异有统计学意义(P<0.05)。结论基于亚肝段功能单元保护的优化放疗可提高患者PTV受照剂量,并减少NTCP及RILD发生。Objective To investigate the application effect of optimized radiotherapy based on hepatic subsegmental function reserve in precision radiotherapy for liver cancer.Methods A total of 60 patients with primary liver cancer treated in the Department of Radiotherapy at Binzhou Central Hospital from January 2018 to December 2020 were selected and randomly divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The control group was treated with three-dimensional conformal radiation therapy(3D-CRT),while the observation group was treated with optimized radiotherapy based on hepatic subsegmental function reserve.The target volume(GTV),the 99%of cumulative irradiated dose for planning target volume(PTV),the mean dose to normal liver(MDTNL),the normal tissue complication probability(NTCP)and the incidence of radiation-induced liver disease(RILD)were compared between the two groups.Results There were no statistically significant differences between the two groups in GTV and MDTNL(P>0.05),but the PTV(D99)of patients in the observation group was significantly higher than that in the control group,with statistically significant differences(P<0.05).The incidence of NTCP and RILD in the observation group was significantly lower than that in the control group,with statistically significant differences(P<0.05).Conclusion Optimized radiotherapy based on hepatic subsegmental function reserve can increase the irradiated dose for PTV and reduce the incidence of NTCP and RILD in patients.

关 键 词：放射治疗 放射性损伤 亚肝段功能单元 形变配准 

分 类 号：R735.7[医药卫生—肿瘤]