影像引导下同步加量调强放疗治疗脑转移瘤的临床研究  

Clinical study of Image-Guided concurrent Intensity-modulated Radiation Therapy for Brain Metastases

作　　者：孔祥虎[1] 白晓平[1] 丁力[1] 李珠明[1] 薛荣梅[1] 胡大海 靳静云 袁牡丹 KONG Xianghu;BAI Xiaoping;DING Li;LI Zhuming;XUE Rongmei;HU Dahai;JIN jingyun;YUAN Mudan(Department of radiotherapy,Baotou Tumor Hospital,Baotou 014030,China)

机构地区：[1]包头市肿瘤医院放疗科,内蒙古包头014030

出　　处：《包头医学院学报》2022年第3期39-42,共4页Journal of Baotou Medical College

摘　　要：目的:研究不同分割方式的图像引导调强适形放射治疗非小细胞肺癌脑转移瘤的临床疗效。方法:将2016年1月至2020年1月就诊于包头市肿瘤医院的96例非小细胞肺癌脑转移患者分为两组。同步加量组(SIB-IGRT组)50例,制定同步加量调强放疗计划:给予全脑照射2 Gy/次,照射20次,共计40 Gy;脑转移灶3 Gy/次,照射20次,共计60 Gy。常规组(RS-IGRT组)46例,制定常规调强放疗计划:给予全脑照射2 Gy/次,照射20次,共计40 Gy;而后脑转移瘤部位序贯补量照射2 Gy/次,照射10次,共计20 Gy。所有患者每周行1次影像引导放射治疗。结果:同步加量组总有效率为78%(39/50),高于常规组的52%(24/46)(P<0.01);两组I~Ⅱ度急性放射性脑损伤发生率无明显差异(P>0.05)。结论:影像引导下同步加量调强放疗能提高脑转移瘤放射治疗精度,提高局部控制率,安全可靠。Objective:To study the clinical efficacy of image-guided intensity-modulated radiation therapy(IGRT)with different segmentation methods in the treatment of brain metastases from non-small cell lung cancer(NSCLC).Methods:From January 2016 to January 2020,96 patients with brain metastases from non-small cell lung cancer were randomly divided into two groups.SIB-IGRT group(50 cases)was given whole brain irradiation of 40 Gy,2 Gy/time,brain metastases of 60 Gy,3 Gy/time,a total of 20 times.In the RS-IGRT group,46 patients were given whole brain irradiation 40 Gy,2 Gy/time,a total of 20 times,followed by sequential supplement of 20Gy,2Gy/time,a total of 10 times;all patients received image-guided radiotherapy once a week.Result:The total effective rate of synchronous dose group was 78%(39/50)higher than that of conventional group 52%(24/46)(P<0.01);there was no significant difference in the incidence of acute radiation-induced brain injury between the two groups(P>0.05).Conclusion:The intensity-modulated radiation therapy with Image-guided may improve precision of radiation therapy,raise rates of local control and ensure safety of treatment for brain metastases.

关 键 词：脑转移瘤 调强放疗 同步加量 影像引导 

分 类 号：R73[医药卫生—肿瘤]