宫颈癌放疗分次间剂量分布映射方法的现状与难点  

Current status and challenges of fractional dose distribution mapping methods in cervical cancer radiotherapy

作　　者：张静[1,3] 赵日 宋建波[2,3] 陈法国 刘兆行 梁润成[1,3] 芦莹 刘鑫 ZHANG Jing;ZHAO Ri;SONG Jianbo;CHEN Faguo;LIU Zhaoxing;LIANG Runcheng;LU Ying;LIU Xin(Nuclear and Radiation Frontier Technology Research Center,China Institute of Radiation Protection,Taiyuan,Shanxi 030006,China;Oncology Center,Shanxi Bethune Hospital,Taiyuan,Shanxi 030006,China;Shanxi Provincial Key Laboratory for Translational Nuclear Medicine and Precision Protection,Taiyuan,Shanxi 030006,China)

机构地区：[1]中国辐射防护研究院核与辐射前沿技术研究中心,山西太原030006 [2]山西白求恩医院肿瘤中心,山西太原030006 [3]核药研发转化与精准防护山西省重点实验室,山西太原030006

出　　处：《中华肿瘤防治杂志》2024年第19期1216-1222,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：山西省基础研究计划(202203021222407)。

摘　　要：目的总结宫颈癌联合治疗中远距离外照射放疗(EBRT)与近距离放疗(BT)联合放疗分次间剂量分布映射方法的现状与难点,特别侧重于基于图像配准的方法、剂量与图像配准的区别及关注点。方法检索PubMed、中国知网及万方期刊全文数据库建库至2023-09-20收录的相关文献,中文关键词为“宫颈癌、剂量分布映射、剂量叠加、图像配准”,英文关键词为“cervical cancer、dose distribution mapping、dose accumulation、image registration”。纳入标准:(1)宫颈癌剂量叠加;(2)宫颈癌分次间剂量分布映射;(3)基于图像配准的宫颈癌剂量叠加。排除标准:(1)低质量文献;(2)内容相似或重复。最终共纳入文献51篇。结果在宫颈癌治疗中,EBRT与BT联合的分次间剂量分布映射存在挑战。治疗过程中由于多器官的复杂厘米级位移和形变,可能导致分次间剂量递送误差。将不同放疗阶段的剂量分布映射传递至参考阶段可能引起误差放大效应,增加了精准放疗的难度。结论准确剂量分布映射方法是精确评估累积生物等效剂量的前提条件,直接利用图像配准将组织/肿瘤剂量分布图映射至参考阶段存在局限性,建议深入研究联合放疗分次间剂量分布映射方法。Objective To discusses the current status and challenges of inter-fractional dose distribution mapping methods in the context of combined external beam radiotherapy(EBRT)and brachytherapy(BT)for cervical cancer,with special focus on the methods based on image registration,and the differences and concerns between dose and image registration.Methods With"cervical cancer,dose distribution mapping,dose accumulation,image registration"as the keywords,the relevant literature was retrieved from PubMed,CNKI and Wanfang databases from the establishment of the database to September 20,2023.Inclusion criteria:(1)Cervical cancer dose accumulation;(2)Inter-fractional dose distribution mapping for cervical cancer;(3)Image registration-based dose accumulation for cervical cancer.Exclusion criteria:(1)Low 64Fquality literature;(2)Similar or repetitive content.A total of 51articles were included.Results In the treatment of cervical cancer,there are challenges in the inter-fractional dose distribution mapping of the combination of EBRT and BT.Complex centimeter-level displacements and deformations of multiple organs during treatment may lead to inter-fractional dose delivery errors.If dose distribution mapping from different radiotherapy stages is transferred to a reference stage,it may lead to error amplification,increasing the difficulty of precision radiotherapy.Conclusions Accurate dose distribution mapping methods are a prerequisite for precise assessment of cumulative biologically equivalent dose.There are limitations in mapping tissue/tumor dose distribution maps to the reference stage directly using image registration.It is recommended to further study on dose distribution mapping methods between fractions in combined radiotherapy.

关 键 词：宫颈癌 联合放疗 剂量分布映射 质量不守恒 综述文献 

分 类 号：R737.33[医药卫生—肿瘤]