喉癌原发灶消退对靶区及OAR剂量的影响  

Effect of primary regression of laryngeal carcinoma on target area and OAR dose

作　　者：杨泽 李元龙 Yang Ze;Li Yuanlong(Yulin Second Hospital,Yulin,Shaanxi i719000,China)

机构地区：[1]陕西省榆林市第二医院,陕西榆林719000

出　　处：《首都食品与医药》2024年第20期40-43,共4页Capital Food Medicine

摘　　要：目的探讨喉癌患者在放射治疗过程中肿瘤消退形成气腔对靶区剂量、适形性指数、均匀性指数以及危及器官(OAR)受照射剂量的影响.方法选取2019年10月-2022年10月我院收治的8例喉癌患者作为研究对象,放疗前行CT扫描,图像命名为CT-1,肿瘤原发灶命名为GTVp,放射治疗技术采用三维适形调强放射治疗技术(IMRT),用Varian Eclipse 13.6计划系统生成计划7F-IMRT1.在放疗20次后行第二次CT扫描,图像命名为CT-2,勾画出靶区内形成的气腔结构命名为air cavity,GTV_(p-air)为原发肿瘤减去出现气腔结构后的肿瘤靶区,其他的靶区不变.用7F-IMRT1相同的优化参数在CT-2的图像上进行优化,生成7F-IMRT2,配对t检验比较两个计划的靶区剂量D_(mean)、D_(95)、D_(90)、D_(5)的变化;适形性指数CI、均匀性指数HI的变化以及危及器官(OAR)受照射剂量的变化.结果喉癌患者在接受放疗20次后会出现气腔,出现气腔后GTV_(p-air)的D_(mean)、D_(95)、D_(90)、D_(5)均略有增加,脑干、脊髓Dmax、D_(mean)、D_(2cc)均略有增加;下颌骨Dmax略有增加,腮腺D_(mean)略有增加,V_(30)几乎无变化;GTVp出现气腔前后适形性指数和均匀性指数差异无统计学意义.结论喉癌在放射治疗过程中随着肿瘤消退会出现气腔效应,使肿瘤受照射剂量与危及器官(OAR)受照射剂量略有增高,适形性指数、均匀性指数无统计学差异,剂量的增加对患者疗效影响较小,但需要考虑危及器官受照射剂量已达限值的患者.Objective To investigate the effects of tumor regression and formation of air cavity on target dose,conformance index,uniformity index and exposure dose of OAR to organs at risk in laryngeal cancer patients during radiotherapy.Methods Eight patients with laryngeal cancer admitted to our department from October 2019 to October 2022 were selected.CT scanning was performed before radiotherapy.The image was named CT-1,the primary tumor was named GTVp,and the radiotherapy technique was three-dimensional conformal intensity modulated radiotherapy(IMRT).Plan system generation plan 7F-IMRT1 with Varian Eclipse 13.6.After 20 times of radiotherapy,a second CT scan was performed,and the image was named CT-2,and the gas cavity structure formed in the target area was outlined and named air cavity.GTV_(p-air)was the tumor target area after the gas cavity structure was subtracted from the primary tumor,and other target areas remained unchanged.The same optimization parameters of 7F-IMRT1 were used to optimize CT-2 images to generate 7F-IMRT2,and the changes of target dose D_(mean),D_(95),D_(90)and D_(5)of the two plans were compared by paired T-test.The change of conformance index CI,homogeneity index HI and the change of exposure dose of OAR in organs at risk.Results After 20 times of radiotherapy,the patients with laryngeal cancer would develop air cavity.After the emergence of air cavity,the D_(mean),D_(95),D_(90)and D_(5)of GTVP-air were slightly increased,and the Dmax,D_(mean)and D_(2cc)of brain stem and spinal cord were slightly increased.Mandibular Dmax was slightly increased,parotid D_(mean)was slightly increased,V_(30)was almost unchanged.There was no statistically significant difference in the conformity index and homogeneity index of GTVp before and after the appearance of the air cavity.Conclusion In the course of radiotherapy,laryngeal cancer will have an air cavity effect with tumor regression,which slightly increases the radiation dose of tumor and the radiation dose of OAR in the organ at risk,and there is no st

关 键 词：喉癌放射治疗 三维适形调强IMRT 气腔 肿瘤靶区 

分 类 号：R739.6[医药卫生—肿瘤]