本文選題：肺癌 + 主動呼吸控制��； 參考：《中華實用診斷與治療雜志》2016年07期

【摘要】：目的探討肺癌放療靶區(qū)勾畫中主動呼吸控制(active breathing control,ABC)技術(shù)配合四維CT、簡易腹部加壓(simple manual epigastric compression,SMEC)技術(shù)配合四維CT對肺活動度、肺部放療體積的影響。方法 50例非小細胞肺癌患者隨機分為主動呼吸組27例,腹部加壓組23例,主動呼吸組行ABC技術(shù)掃描和自由呼吸掃描,腹部加壓組行SMEC技術(shù)和自由呼吸掃描,重建掃描圖像后進行靶區(qū)勾畫。比較ABC技術(shù)與自由呼吸掃描,SMEC技術(shù)和自由呼吸掃描模式下肺腫瘤左右(right-left,RL)、頭腳(superior-inferior,SI)、前后(anterior-posterior,AP)運動幅度,依據(jù)劑量體積直方圖評價兩種技術(shù)雙肺V_5、V_(10)、V_(20)、V_(30)劑量體積及總劑量體積(V_總)。結(jié)果主動呼吸組ABC掃描下肺腫瘤SI運動幅度[(5.04±0.64)mm]低于自由呼吸掃描[(15.58±0.71)mm](P0.05),RL、AP運動幅度與自由呼吸掃描比較差異無統(tǒng)計學(xué)意義(P0.05);腹部加壓組SMEC技術(shù)掃描下肺SI運動幅度[(5.18±1.12)mm]低于自由呼吸掃描[(16.14±2.21)mm](P0.05),RL、AP運動幅度與自由呼吸掃描比較差異無統(tǒng)計學(xué)意義(P0.05);主動呼吸組ABC掃描下雙肺V_5、V_(10)、V_(20)、V_(30)[(52.74±4.78)%、(38.76±4.92)%、(23.71±4.03)%、(15.54±3.43)%]均低于自由呼吸掃描[(62.54±5.63)%、(45.58±5.84)%、(29.02±5.10)%、(19.18±4.61)%](P0.05),V_總[(3 725.00±184.41)cm3]高于自由呼吸掃描[(3 125.00±219.92)cm3](P0.05);腹部加壓組SMEC掃描下雙肺V_5、V_(10)、V_(20)、V_(30)、V_總[(61.47±4.93)%、(43.89±4.74)%、(27.38±3.97)%、(17.77±3.56)%、(3 475.00±214.12)cm3]均低于自由呼吸掃描[(62.54±5.61)%、(45.58±5.40)%、(29.00±5.11)%、(19.18±4.62)%、(3 567.00±235.31)cm3](P0.05);ABC掃描時SI、AP運動幅度與SMEC技術(shù)掃描比較差異無統(tǒng)計學(xué)意義(P0.05),RL運動幅度低于SMEC技術(shù)掃描(P0.05);ABC掃描時V_5、V_(10)、V_(20)、V_(30)低于SMEC技術(shù)掃描,V總高于SMEC技術(shù)掃描(P0.05)。結(jié)論 ABC、SMEC技術(shù)配合四維CT均可有效減小肺腫瘤SI方向的呼吸動度,ABC技術(shù)在肺癌放療靶區(qū)勾畫中縮小V_5、V_(10)、V_(20)劑量體積及增加V總上效果明顯。
[Abstract]:Objective to investigate the effects of active breathing control (ABC) technique combined with four-dimensional CTC and simple manual epigastric compression technique (SMC) combined with four-dimensional CT (Four-dimensional CT) on lung activity and lung radiation volume in lung cancer radiotherapy target. Methods Fifty patients with non-small cell lung cancer were randomly divided into active breathing group (n = 27) and abdominal compression group (n = 23). ABC scanning and free breathing scanning were performed in active breathing group and SMEC technique and free breathing scan were performed in abdominal compression group. The image was reconstructed and the target area was delineated. To compare the range of motion between ABC technique and free respiratory scanning (SMEC) technique and free breath scanning mode, and to evaluate the dose volume and total dose volume of V5V10VC20 / VDV) in bilateral lung V5V10V10V / V ~ (30) by comparing the amplitude of motion of left and right left side of lung tumor, head and foot of superior inferiorus siella, anterior and posterior anterior posteriorus under the mode of free breath scanning and free breathing scanning. The two techniques were used to evaluate the dose volume and the total dose volume of V5V10VC20 / VDV in the two kinds of techniques according to the dose-volume histogram. Results the SI motion amplitude of lung tumor in active breathing group [5.04 鹵0.64)mm] was lower than that in free breath scan [15.58 鹵0.71)mm] P0.05RLAP, there was no significant difference between P0.05 and free breathing scan, and the SI motion amplitude of lung in abdominal compression group was 5.18 鹵1.12)mm under SMEC scanning. 浜庤嚜鐢卞懠鍚告壂鎻廩(16.14鹵2.21)mm](P0.05),RL,AP榪愬姩騫呭害涓庤嚜鐢卞懠鍚告壂鎻忔瘮杈冨樊寮傛棤緇熻瀛︽剰涔，

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