本文關鍵詞： 錐形束CT 立體定向放療 肺部腫瘤 擺位誤差　出處：《中國癌癥雜志》2017年06期 　論文類型：期刊論文

【摘要】：背景與目的:準確的靶區(qū)位置是肺部腫瘤立體定向放療的重要影響因素。該研究旨在分析在肺部腫瘤患者立體定向放療中基于錐形束CT(cone-beam CT,CBCT)影像的擺位誤差及其影響因素。方法:29例單發(fā)肺部惡性腫瘤行立體定向放療的患者,每次放療前行CBCT掃描,將得到的CBCT圖像與定位CT圖像匹配,獲得前后、頭腳和左右方向的擺位誤差值,并計算臨床靶區(qū)(clinical target volume,CTV)外擴至計劃靶區(qū)(planning target volume,PTV)的邊界。同時,還分析對可能影響擺位誤差的臨床參數(shù)等進行分層比較。結果:29例患者共獲得155幅CBCT圖像。考慮誤差方向時前后、頭腳和左右方向擺位誤差分別為(-1.68±3.62)、(-1.34±3.90)和(0.36±2.15)mm,只考慮誤差數(shù)值大小時分別為(3.16±2.42)、(3.29±2.48)和(1.74±1.30)mm。根據(jù)擺位誤差得到CTV外擴至PTV的邊界在前后、頭腳和左右方向分別為9.6、10.0和5.3 mm。病灶位于周圍的肺部腫瘤患者前后方向擺位誤差更大(P=0.007),下肺病灶、右肺病灶、肺轉(zhuǎn)移灶在頭腳方向擺位誤差更大(P=0.008、0.000和0.000)。結論:肺部腫瘤患者放療中的頭腳和前后方向擺位誤差較大,立體定向放療需采用錐形束CT掃描、呼吸控制等技術以減少擺位誤差。
[Abstract]:Background & objective: accurate target location is an important influencing factor of stereotactic radiotherapy for lung tumors. This study was designed to analyze the positioning errors and their images based on cone-beam CT(cone-beam CT images in patients with lung tumors. Methods Twenty-nine patients with single lung malignant tumor received stereotactic radiotherapy. Each time before radiotherapy, CBCT scan was performed, the obtained CBCT images were matched with the positioning CT images, and the errors of the front and back, the head and feet, the left and right directions were obtained, and the clinical target area was expanded to the boundary of the planned target area (target volumePTV). At the same time, The stratified comparison of clinical parameters that may affect the error of pendulum was also analyzed. Results A total of 155 CBCT images were obtained from 29 patients with different errors. The position errors of head and foot were -1.68 鹵3.62mm-1. 34 鹵3.90) and 0.36 鹵2.15mm respectively. When the error value was only taken into account, the errors were 3.16 鹵2.42kg 3.29 鹵2.48mm and 1.74 鹵1.30mmm. according to the pendulum error, the boundary between CTV and PTV was obtained. The head and foot and left and right directions were 9.6m10.0 and 5.3 mm. the foci were located in the surrounding lung tumor patients with greater alignment error (P < 0.007), lower lung lesions, right lung lesions, and the right lung lesions, the right lung lesions, the lower lung lesions, the right lung lesions, and the right lung lesions. The error in head and foot direction of lung metastases is greater than that in head and foot. Conclusion: the error of head and foot in head and foot of lung tumor patients with radiotherapy is larger. Conical beam CT scan and respiratory control should be used in stereotactic radiotherapy in order to reduce the error of pendulum position.
【作者單位】： 復旦大學附屬腫瘤醫(yī)院放射治療科 復旦大學上海醫(yī)學院腫瘤學系;上海交通大學醫(yī)學院附屬瑞金醫(yī)院放射治療科;
【分類號】：R730.44;R734.2

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