基于4D-CT的三种呼吸门控技术对肺癌立体定向放射治疗计划靶区及正常组织器官体积、受照剂量的影响  

Effects of three respiratory gating techniques based on 4D-CT on planning target volume and the volume and radiation dose of normal tissues and organs in patients undergoing stereotactic body radiotherapy for lung cancer

作　　者：管浩然 闫冰 李骁扬 李迪迪 吴广军 吴齐兵[3] GUAN Haoran;YAN Bing;LI Xiaoyang;LI Didi;WU Guangjun;WU Qibing(School of Biomedical Engineering,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学生物医学工程学院,安徽合肥230032 [2]中国科学技术大学附属第一医院安徽省立医院肿瘤放疗科,安徽合肥230001 [3]安徽医科大学第一附属医院肿瘤放疗科,安徽合肥230022 [4]安徽医科大学临床医学院,安徽合肥230012

出　　处：《陕西医学杂志》2024年第7期926-930,共5页Shaanxi Medical Journal

基　　金：安徽省教育厅高校学科(专业)拔尖人才学术资助项目(GXBJZD2021049)。

摘　　要：目的:探讨基于4D-CT的三种呼吸门控技术对肺癌立体定向放射治疗(SBRT)计划靶区及正常组织器官体积、受照剂量的影响。方法:收集108例肺癌患者的病例资料,比较患者在基于4D-CT的三种呼吸门控技术下接受SBRT治疗的肿瘤靶区(GTV)、计划靶区(PTV)体积和受照剂量,并比较三种呼吸门控技术下正常组织的受照剂量。结果:三种不同技术下,患者GTV与PTV体积比较存在统计学意义差异(均P<0.05),其中自由呼吸(FB)技术下的GTV与PTV体积较主动呼吸控制(ABC)、呼吸门控(RG)技术下高,RG技术下GTV与PTV体积较ABC技术下高(均P<0.05);三种不同技术下PTV受照剂量参数靶区适形度指数(CI)水平差异无统计学意义(均P>0.05);三种不同技术下PTV受照剂量参数靶区剂量均匀性指数(HI)、GI水平差异有统计学意义(均P<0.05);其中FB技术下的GI较ABC技术和RG技术下低,HI水平较ABC技术和RG技术下高,ABC技术下的HI水平较RG技术下低(均P<0.05);三种不同技术下心脏、大血管、气管、食管以及脊髓的受照剂量比较差异无统计学意义(均P>0.05);三种不同技术下双肺V_(5)、V_(20)以及平均照射剂量(MLD)比较差异有统计学意义(均P<0.05);FB技术下的V_(5)、V_(20)以及MLD较ABC、RG技术下高,RG技术下V_(5)、V_(20)以及MLD较ABC技术下高(均P<0.05)。结论:基于4D-CT的ABC与RG技术相较于FB技术更有利于缩小靶区体积,提高治疗剂量,同时更有利于降低病灶危及器官与组织的受照剂量。Objective:To investigate the effects of three respiratory gating techniques based on four-dimensional computed tomography(4D-CT)on planning target volume(PTV)and the volume and radiation dose of normal tissues and organs in patients undergoing stereotactic body radiotherapy(SBRT)for lung cancer.Methods:The medical records of 108 lung cancer patients were collected retrospectively.The gross tumor volume(GTV),PTV and radiation doses of patients receiving SBRT with three different respiratory gating techniques based on 4D-CT were compared.The radiation doses of normal tissues under the three respiratory gating techniques were compared.Results:There were statistically significant differences in GTV and PTV under the three different techniques(all P<0.05).GTV and PTV under free breathing(FB)technique were larger than those under active breathing control(ABC)technique and respiratory gating(RG)technique.Meanwhile,GTV and PTV under RG technique were larger than those under ABC technique(all P<0.05).There was no statistically significant difference in radiation dose parameter,Conformity Index(CI),of PTV under the three different techniques(all P>0.05).However,there were statistically significant differences in radiation dose parameters[Homogeneity Index(HI)and GI]of PTV under the three different techniques.GI under FB technique was lower than that under ABC technique and RG technique,HI was higher than that under ABC technique and RG technique,HI under ABC technique was lower than that under RG technique(all P<0.05).There was no statistically significant difference in radiation dose of the heart,great vessels,trachea,esophagus,or spinal cord under the three different techniques(all P>0.05).V_(5) and V_(20) of bilateral lungs,and mean lung dose(MLD)under the three different techniques were significantly different(all P<0.05).V_(5),V_(20),and MLD under FB technique were higher than those under ABC technique and RG technique.V_(5),V_(20),and MLD under RG technique were higher than those under ABC technique(all P<0.05).Concl

关 键 词：4D-CT 呼吸门控技术 肺癌 立体定向放射治疗 计划靶区 受照剂量 

分 类 号：R734.2[医药卫生—肿瘤]