M6型射波刀立体定向放疗系统追踪肺部肿瘤的运动规律及影响因素的研究  

Study on the movement patterns and influencing factors of lung tumors tracked by M6 cyberknife stereoscopic radiotherapy system

作　　者：牛泽乾 宋勇春 袁智勇 王境生 董洋 于旭耀 陈华明 田啸林 Zeqian Niu;Yongchun Song;Zhiyong Yuan;Jingsheng Wang;Yang Dong;Xuyao Yu;Huaming Chen;Xiaolin Tian(Department of Radiotherapy,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放疗科,国家恶性肿瘤临床医学研究中心,天津市"肿瘤防治"重点实验室,天津市恶性肿瘤临床医学研究中心,天津市300060

出　　处：《中国肿瘤临床》2025年第2期71-74,共4页Chinese Journal of Clinical Oncology

基　　金：天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-009A);天津医科大学肿瘤医院“358计划”临床试验基金项目(编号:358-2023-15)资助。

摘　　要：目的:探讨M6型射波刀立体定向放疗(stereotactic radiotherapy,SRT)系统追踪肺部肿瘤的运动规律及影响因素,为实施精准SRT肺部肿瘤提供参考依据。方法:回顾性分析天津医科大学肿瘤医院2022年1月至2024年8月29例采用M6型射波刀SRT系统肺追踪技术治疗的肺部肿瘤患者,统计患者的肿瘤位置、肿瘤体积、照射剂量、等剂量线、分割次数等资料。按照肺部肿瘤位置进行分类,采用SPSS 26.0软件分析肿瘤左右(LFT/RGT,LR)、前后(ANT/POS,AP)、头脚(SUP/INF,SI)方向的运动幅度,以x±s表示,采用t检验进行组间比较。采用多元线性回归分析年龄、性别、肿瘤位置、肿瘤体积对肺部肿瘤运动幅度的影响。结果:19例上肺的肿瘤,10例下肺的肿瘤LR、AP、SI方向的运动幅度分别为(3.5±1.8)mm、(5.3±1.7)mm、(7.3±5.4)mm;(3.1±1.6)mm和(4.5±2.2)mm、(12.2±4.4)mm。SI方向上,下肺肿瘤和上肺肿瘤的运动幅度相比较,差异具有统计学意义(P=0.0153)。LR、AP方向上,两者差异无统计学意义(P>0.05)。SI方向上,肺部肿瘤的运动幅度受到肿瘤位置的影响(P=0.035)。LR、AP方向上,肺部肿瘤的运动幅度与性别、年龄、肿瘤位置、肿瘤体积因素无关。结论:不同位置、方向的肺肿瘤运动幅度受患者呼吸运动影响不同。SI方向上,受到肿瘤位置的影响,下肺肿瘤运动幅度比上肺肿瘤运动幅度大。LR、AP方向上,下肺肿瘤和上肺肿瘤的运动幅度接近,不受性别、年龄、肿瘤位置、肿瘤体积的影响。Objective:To explore the movement patterns and factors influencing lung tumors tracked using the M6 cyberknife stereotactic radiotherapy(SRT)system and to provide a reference for the implementation of precise stereotactic radiotherapy for lung tumors.Method:A retrospective analysis was conducted on 29 patients with lung tumors who were treated using x-sight lung tracking technology and the M6 cyberknife SRT system at Tianjin Medical University Cancer Institute&Hospital,from January 2022 to August 2024.The tumor location and volume,irradiation dose,isodose line,and number of divisions were recorded.Lung tumor location and SPSS 26.0 software were used to analyze the movement amplitude of tumors in the left and right(LFT/RGT,LR)directions,the anterior-posterior(ANT/POS,AP)direction,and the superior-inferior(SUP/INF,SI)direction.The results are expressed as the mean±standard deviation(x±s)mm,and a t-test was used for inter-group comparisons.Multiple linear regression was used to analyze the effects of factors such as age,gender,tumor location(upper and lower lungs),and tumor volume on the amplitudes of the lung tumor movements.Result:The average motion amplitudes in the LR directions,AP direction,and SI direction of the tumor target areas were(3.5±1.8)mm,(5.3±1.7)mm,and(7.3±5.4)mm for the upper lung,based on 19 cases,and(3.1±1.6)mm,(4.5±2.2)mm,and(12.2±4.4)mm for the lower lung,based on 10 cases,respectively.There was a statistically significant difference(P=0.0153)in the amplitude of movements between the lower and upper lung tumors in the SI direction.The lung tumor movement amplitude in the SI direction was influenced by tumor location(P=0.035),and the movement amplitudes in the LR directions and the AP direction were not related to factors such as gender,age,tumor location,and tumor volume.Conclusions:The lung tumor movement amplitudes for the different locations varied depending on the respiratory movement shown by the patient.In the SI direction,the movement amplitude of the lower lung tumors was greate

关 键 词：M6型射波刀立体定向放疗 肺追踪技术 肺肿瘤 运动幅度 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]