杨柳婷, 陈龙, 黄江琼, 付庆国. 非小细胞肺癌自适应放疗剂量学研究[J]. 中国肿瘤临床, 2014, 41(21): 1353-1357. DOI: 10.3969/j.issn.1000-8179.20140974
引用本文: 杨柳婷, 陈龙, 黄江琼, 付庆国. 非小细胞肺癌自适应放疗剂量学研究[J]. 中国肿瘤临床, 2014, 41(21): 1353-1357. DOI: 10.3969/j.issn.1000-8179.20140974
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YANG Liuting, CHEN Long, HUANG Jiangqiong, FU Qingguo. Potential of adaptive radiotherapy to escalate the radiation dose for non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(21): 1353-1357. DOI: 10.3969/j.issn.1000-8179.20140974
Citation: YANG Liuting, CHEN Long, HUANG Jiangqiong, FU Qingguo. Potential of adaptive radiotherapy to escalate the radiation dose for non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(21): 1353-1357. DOI: 10.3969/j.issn.1000-8179.20140974
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非小细胞肺癌自适应放疗剂量学研究

Potential of adaptive radiotherapy to escalate the radiation dose for non-small cell lung cancer

    摘要
  • 摘要:
      目的  探索非小细胞肺癌实施自适应放疗后危及器官(肺、心脏、脊髓)受照剂量的变化, 及危及器官受照剂量降低后靶区处方剂量的变化。
      方法  12例局部晚期非小细胞肺癌患者在放疗过程中均行两次定位CT扫描, 以实行自适应放疗。通过MIM软件, 将两次计划进行融合。比较实行自适应放疗后, 保证靶区剂量不变的情况下, 危及器官的受量有无降低; 以及在保证正常组织器官受照剂量与原计划相似的情况下靶区剂量提升的空间。
      结果  自适应放疗后, 在保证靶区受照剂量不变的情况下, 肺部V20平均降低3.53%, V30降低2.55%, 而全肺平均受照剂量降低2.11 Gy; 心脏V30平均降低4.19%、V40降低3.72%;脊髓最大受量平均降低3.52 Gy。危及器官受量与不行自适应放疗时相似的情况下, 靶区(PGTV)照射剂量平均提高1.25 Gy。
      结论  非小细胞肺癌放疗过程中, 适时行自适应放疗能够减少周围危及器官的受照剂量, 提高靶区(PGTV)的处方剂量。

     

    Abstract:
      Objective  To evaluate the potential dose influence to organs at risk (OARs) and targets of adaptive radiotherapy (ART) for non-small cell lung cancer (NSCLC).
      Methods  Twice positional CT images of 12 patients with locally advanced NSCLC were captured during radio-(n=3) or radio-chemotherapy (n=9) for ART simulation.The twice positional scanningplan was fused using MIM software.The variation of irradiation doses for the lung, heart, and spinal cord was evaluated, and the prescription doses for the targets were escalated.
      Results  Adaptive radiation enabled dose reduction by an average of 3.53% for lung V20 and by 2.55% for V30. The mean dose for the lung decreased by 2.11 Gy.The dose was reduced by an average of 4.17% for heart V30 and by 3.37% for V40. Meanwhile, the maximum dose for the spinal cord was reduced by 3.52 Gy on average.Lung sparing with ART enabled an iso-mean lung dose escalation of the Planning gross tumor target volume dose, which improved by an average of 1.25 Gy.
      Conclusion  The adaptation of radiotherapy for continuous tumor shrinkage during the treatment course for NSCLC reduces doses to OARs, enables significant dose escalation, and has the potential to increase local control.

     

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