【摘要】：目的:探討鼻腔內(nèi)腫瘤調(diào)強(qiáng)放療時舌的位置與劑量學(xué)關(guān)系。方法:對5例2011-11-02-2012-08-31華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院經(jīng)病理和影像確診局限于鼻腔內(nèi)腫瘤患者,在治療計劃系統(tǒng)中測量舌到硬腭的距離并計算其劑量,測量5例患者142次治療擺位完成后錐形束CT(conebeam CT,CBCT)影像中的舌到硬腭的距離,并在治療計劃系統(tǒng)中模擬計算舌在該位置的劑量。結(jié)果:治療計劃定位時舌到硬腭的距離為0.00~1.10cm,治療擺位時為0.00~0.95cm,治療時舌的位置與定位時的重合率僅為3.52%,各例患者舌位置差異均值在0.10~0.35cm,劑量差異最大可達(dá)30.01Gy。結(jié)論:局限于鼻腔內(nèi)腫瘤調(diào)強(qiáng)放療時,作為毗鄰器官舌的位置不易重復(fù)和固定,導(dǎo)致劑量差異。建議采用適當(dāng)形狀和組織等密度材料的壓舌板予以固定,使舌遠(yuǎn)離硬腭以減小其所受劑量。
[Abstract]:Objective: to investigate the relationship between tongue position and dose during intensity-modulated radiotherapy (IMRT) for nasal tumors. Methods: five cases of Tongji Hospital affiliated to Tongji Medical College, Tongji University of Science and Technology, Huazhong University of Science and Technology, were selected and confirmed by pathology and imaging. The distance between tongue and hard palate was measured and the dose was calculated in the treatment planning system. The distance between tongue and hard palate in CT (conebeam CT,CBCT images of 5 patients was measured and the dose of tongue in this position was simulated in the treatment planning system. Results: the distance between the tongue and the hard palate was 0.0010 cm and 0.000.95 cm respectively. The coincidence rate between the position of the tongue and the position of the hard palate was only 3.52 cm. The mean value of the position of the tongue was 0.10 ~ 0.35 cm. The maximum dose difference was 30.01Gy. Conclusion: it is difficult to repeat and fix the position of tongue as an adjoining organ during intensity-modulated radiotherapy in nasal cavity, which leads to the difference of dose. It is suggested that the tongue press plate with proper shape and tissue density should be used to keep the tongue away from the hard palate in order to reduce its dose.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院腫瘤科;
【分類號】：R739.62

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