| 霍俊杰,乔学英,曹彦坤,等.食管胸中段癌三维适形放疗中呼吸运动导致靶区移位的研究[J].中华放射医学与防护杂志,2010,30(3):295-298.HUO Jun-jie,QIAO Xue-ying,CAO Yan-kun,et al.Evaluation of respiration-induced target volume motion in three-dimensional conformal radiotherapy (3D-CRT) for mid-thoracic esophageal carcinoma[J].Chin J Radiol Med Prot,2010,30(3):295-298 |
| 食管胸中段癌三维适形放疗中呼吸运动导致靶区移位的研究 |
| Evaluation of respiration-induced target volume motion in three-dimensional conformal radiotherapy (3D-CRT) for mid-thoracic esophageal carcinoma |
| 投稿时间：2009-07-27 |
| DOI：10.3760/cma.j.issn.0254-5098.2010.03.017 |
| 中文关键词: 食管胸中段癌 三维适形放疗 呼吸运动 靶区移位 |
| 英文关键词:Mid-thoracic esophageal carcinoma 3D-conformal radiotherapy Respiratory movement Target volume motion |
| 基金项目:河北省卫生厅医学科学研究重点课题(07290);河北省普通高校强势特色学科资助项目(2005-52) |
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| 中文摘要: |
| 目的 测量食管胸中段癌三维适形放疗中因呼吸运动而导致的靶区移位大小,为临床医师选择食管胸中段癌靶区外扩范围提供参考。方法 对10例食管胸中段癌患者行三维适形放疗定位时,分别于自由呼吸(FB)、自由吸气末屏气(IBH)及自由呼气末屏气(EBH)3个时相行相同范围的CT定位扫描。3套图像传输到计划系统并按照相同标准进行靶区的勾画。测量3种不同呼吸状态之间的大体肿瘤靶区(GTV)中心点移位、GTV每层中心点移位、感兴趣层面的GTV边缘形变移位,得到包含全部数值的综合值。并根据GTV移位的95%置信区间推断合适的内边界(IM)值。结果 1测量GTV中心点为左右方向(0.19±0.16)cm,头脚方向(0.54±0.19)cm,前后方向(0.16±0.14)cm;每层中心点分别为(0.19±0.15)cm、(0.54±0.16)cm和(0.16±0.13)cm;边缘分别为(0.26±0.19)cm、(0.54±0.18)cm和(0.24±0.19)cm;各方向含全部数值的综合值分别为(0.23±0.17)cm、(0.54±0.17)cm和(0.21±0.17)cm。其95%置信区间,左右、头脚和前后方向分别为0.21~0.25 cm、 0.53~0.56 cm和0.19~0.22 cm。2以EBH为基准,在IBH时左右方向,未发生移位的占8.2%,向右移位的占73.3%,向左移位的占18.5%;在头脚方向均向脚侧移位［(0.54±0.17) cm］;在前后方向,未发生移位的占8.2%,向后移位的占16.6%,向前移位的占75.2%。3GTV移位与IBH-EBH之间双肺体积变化值呈正相关(r=0.683,P=0.032),与GTV体积及长度均无相关。结论 在食管胸中段癌的三维适形放疗中,呼吸运动可导致GTV移位,IBH较EBH时趋于向脚侧、向前、向右移位。 |
| 英文摘要: |
| Objective To evaluate the respiration-induced target volume motion in 3D-CRT for mid-thoracic esophageal carcinoma in order to guide the radiation oncologist to choose the expansion margin for ITV. Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CT simulator respectively in free breathing (FB), breath-hold after normal inspiration and expiration (IBH and EBH) with the same scanning range. Then the CT images of three series were transferred to the treatment planning system. The target volume was outlined following the same standard. The motion of the center point of GTV, the center point of each slice of GTV and the edge of the GTV in selected slice were measured respectively to obtain the comprehensive value of GTV motion, in order to find the appropriate IM value according to the 95% confidence interval of the GTV motion. Results 1 The GTV motion between IBH and EBH was (0.19±0.16) cm in the left-right direction, (0.54±0.19) cm in the cranial and caudal direction, and (0.16±0.14) cm in anterior-posterior directions for the center of GTV,. For the center point of each slice of GTV . they were (0.19±0.15) cm, (0.54±0.16) cm, (0.16±0.13) cm in three directions above, respectively. For the edge of the GTV in selected slice, they were (0.26±0.19) cm, (0.54±0.18) cm, (0.24±0.19) cm, respectively. The comprehensive value of GTV motion between IBH and EBH was (0.23±0.17) cm, (0.54±0.17) cm, (0.21±0.17) cm, respectively. The 95% confidence interval was 0.21-0.25 cm, 0.53-0.56 cm and 0.19-0.22 cm in three directions. 2The direction of GTV motion: No motion was noticed in 8.2%, while 73.3% to the right side and 18.5% to the left side in the left-right direction when IBH were compared with EBH. 100% were moved to caudal in the the cranial and caudal direction ［(0.54±0.17) cm］. In the anterior-posterior direction, no motion was noticed in 8.2%, while 16.6% to the posterior and 75.2% to the anterior when IBH were compared with EBH. 3The GTV motion was correlated with the variance of lung volumes in IBH-EBH (r=0.683, P=0.032) and not with GTV volume and length. Conclusions Respiration can induce target volume motion in 3DCRT for mid-thoracic esophageal carcinoma. Compared to EBH, the GTV tends to move to the caudal, the anterior and the right side in IBH. |
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