| 宋纪萍,朱益平,邱 强,王朝霞,王 楠.CBCT引导放疗摆位误差对中上段食管癌患者受照射剂量的影响[J].,2021,(18):3592-3595 |
| CBCT引导放疗摆位误差对中上段食管癌患者受照射剂量的影响 |
| Effects of CBCT-guided Radiotherapy Set-up Errors on Irradiation Dose in Patients with Upper and Middle Esophageal Cancer |
| 投稿时间：2020-12-05 修订日期：2020-12-29 |
| DOI：10.13241/j.cnki.pmb.2021.18.042 |
| 中文关键词: 锥形束CT 摆位误差 放疗 食管癌 受照射剂量 |
| 英文关键词: Cone beam CT Set-up errors Radiotherapy Esophageal cancer Irradiation dose |
| 基金项目:安徽省高校自然科学研究项目（KJ2017A262） |
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| 中文摘要: |
| 摘要 目的：探究锥形束CT（CBCT）引导放疗摆位误差对中上段食管癌患者受照射剂量的影响。方法：选取2017年5月～2019年5月于我院收治的60例中上段食管癌患者为研究对象，所有患者均行CBCT图像、计划CT图像采集。在患者放疗前进行CBCT扫描，将CBCT图像与计划CT图像匹配，得到左右（x轴）、头脚（y轴）、前后（z轴）三个方向的线性误差，分析出现的误差及误差的分布规律。利用模拟实际照射系统，进行模拟计划，得到实际照射靶区及正常组织受照射剂量，将其与治疗前计划比较，研究摆位误差对患者受照剂量的影响。结果：患者整体摆位误差为x轴（2.91±2.20）mm，y轴（3.89±2.17）mm，z轴（2.44±1.64）mm，x轴的MPTV为4.054 mm，y轴的MPTV为8.183 mm，z轴的MPTV为3.482 mm。模拟计划的CI、PTV的Dmin、Dmean、D95%均低于标准计划差异显著（P均＜0.05），而模拟计划的HI低于标准计划（P＜0.05）。模拟计划的脊髓Dmax高于标准计划（P＜0.05），而标准计划与模拟计划的双肺V20、Dmean，心脏V40差异比较无统计学意义（P均＞0.05）。结论：CBCT引导放疗摆位误差对中上段食管癌患者影响较小，提高PTV受照射剂量及治疗准确程度，对脊髓有保护效果。摆位误差对心、肺的剂量分布无明显影响。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of cone beam CT (CBCT)-guided radiotherapy set-up errors on irradiation dose of patients with upper and middle esophageal cancer. Methods: A total of 60 patients with middle and upper esophageal cancer admitted to our hospital from May 2017 to May 2019 were selected as the research subjects. All patients underwent CBCT images and planned CT image acquisition. CBCT scan was performed on patients before radiotherapy, and the CBCT image was matched with the planned CT image to obtain linear errors in three directions of left-right (x-axis), head-to-foot (y-axis) and front-to-back (z-axis), and the errors and distribution of errors were analyzed. The simulated actual irradiation system was used to carry out a simulation plan to obtain the actual irradiation target area and the irradiation dose of normal tissues, and compared it with the pre-treatment plan, and the effects of set-up errors on irradiation dose of patients were studied. Results: The overall set-up error of patients was(2.91±2.20) mm in x-axis, (3.89±2.17) mm in y-axis and (2.44±1.64) mm in z-axis, and the MPTV of x-axis was 4.054 mm, and MPTV of y-axis was 8.183 mm and MPTV of z-axis was 3.482 mm. The Dmin, Dmean and D95% of CI and PTV of the simulation plan were significantly lower than those of the standard plan (all P<0.05), and the HI of simulation plan was lower than that of standard plan (P<0.05). The spinal cord Dmax of simulation plan was higher than that of standard plan(P<0.05), and there were no significant differences in the lung V20 and Dmean and heart V40 between standard plan and simulation plan(all P>0.05). Conclusion: CBCT-guided radiotherapy set-up errors have little effects on patients with upper and middle esophageal cancer. It improves the PTV irradiation dose and the treatment accuracy, and has a protective effect on spinal cord. Set-up errors have no significant effects on the dose distribution of the heart and lung. |
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