【摘要】：目的:探討圖像引導(dǎo)放射治療(image guided radiation therapy,IGRT)技術(shù)在測定并校正肺部惡性腫瘤體部立體定向放射治療(stereotactic body radiation therapy,SBRT)過程中靶區(qū)位置誤差的意義。方法:選擇復(fù)旦大學(xué)附屬腫瘤醫(yī)院收治的14例肺部惡性腫瘤并接受SBRT的患者。每次治療前后均進行千伏級錐形束CT(kV-CBCT)掃描,與計劃CT圖像進行在線配準(zhǔn),校正誤差后進行治療。治療后再次進行CBCT掃描并配準(zhǔn)。分別記錄治療前后靶區(qū)位置誤差。根據(jù)臨床靶區(qū)(CTV)-計劃靶區(qū)(PTV)外放公式MPTV(外放)=2.5Σ+0.7σ計算PTV外擴大小。結(jié)果:治療前靶區(qū)位置左右、頭腳、腹背方向誤差最大值分別為10.0mm、16.9mm、8.7mm,誤差平均值分別為(2.4±2.8)mm、(3.4±4.6)mm、(2.9±3.4)mm。在線校正并治療后,靶區(qū)位置左右、頭腳、腹背方向的誤差最大值分別為7.6mm、4.6mm、7.0mm,誤差平均值分別為(2.1±2.0)mm、(1.5±1.6)mm、(1.7±2.0)mm。無圖像引導(dǎo)PTV外擴大小為左右7.96mm、頭腳11.72mm、腹背9.63mm,有圖像引導(dǎo)并在線校正PTV外擴大小為左右6.65mm、頭腳4.87mm、腹背5.65mm。結(jié)論:IGRT技術(shù)可即時校正SBRT治療前由擺位引起的靶區(qū)位置誤差,并測定治療過程中的靶區(qū)位置移動,能提高治療精度,并有助于PTV外擴的制定。
[Abstract]:Objective: to investigate the significance of image guided radiotherapy (image guided radiation therapy,IGRT) technique in the determination and correction of target position errors during stereotactic radiotherapy (stereotactic body radiation therapy,SBRT) for lung malignant tumors. Methods: 14 patients with pulmonary malignant tumor and receiving SBRT were selected from tumor Hospital of Fudan University. CT (kV-CBCT) scanning of KV conical beam was performed before and after each treatment, and then the planned CT images were registered online, and the errors were corrected and treated. CBCT scan and registration were performed again after treatment. Target position errors were recorded before and after treatment. According to the (PTV) extrapolation formula of clinical target (CTV)-planned target area MPTV = 2. 5 危 0.7 蟽 the size of PTV extraneous expansion was calculated. Results: before treatment, the maximum errors of target area, head, foot and ventral dorsal direction were 10.0 mm / 16.9 mm / 8.7mm, respectively, and the average error values were (2.4 鹵2.8) mm, () 3.4 鹵4.6) mm, (2.9 鹵3.4 mm., respectively. After on-line correction and treatment, the maximum errors of target position, head and foot, and dorsal direction of abdomen were 7.6mm / 4.6mm / 7.0mm, respectively, and the average error values were (2.1 鹵2.0) mm, (/ 1.5 鹵1.6) mm, respectively. (1.7 鹵2.0) mm. The size of PTV was 7.96mm, 11.72mm, 9.63mm, respectively. The size of PTV was 6.65 mm, 4.87 mm and 5.65 mm respectively, and the size of PTV was about 6.65 mm, 4.87 mm and 5.65 mm respectively. Conclusion: the IGRT technique can correct the target position error caused by pendulum immediately before SBRT treatment, and measure the target position movement in the course of treatment, which can improve the treatment accuracy and contribute to the formulation of PTV extranodation.
【作者單位】： 復(fù)旦大學(xué)附屬腫瘤醫(yī)院放療科復(fù)旦大學(xué)上海醫(yī)學(xué)院腫瘤學(xué)系;上海交通大學(xué)附屬胸科醫(yī)院放療科;
【分類號】：R734.2;R730.55

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