摘要
目的探讨PET-CT在局部晚期胰腺癌(local advanced pancreatic carcinoma,LAPC)三维适形放射治疗(three dimensional conformal radiotherapy,3D-CRT)靶区勾画中的价值,为基于PET-CT的精确放疗方案制定奠定基础。方法13例局部晚期胰腺癌确诊患者,分别采用PET-CT融合图像及同机CT图像勾画靶区体积,对比分析肿瘤靶区(GTV)、临床靶区(CTV)、计划靶区(PTV)、周围正常组织受量等指标。结果 PET-CT改变GTV、PTV:13例患者靶体积均有改变,GTVCT、GTVPET-CT分别为(57.3±22.9)、(68.4±31.7)cm3,CTVCT、CTVPET-CT分别为(119.9±38.7)、(132.7±47.5)cm3,PTVCT、PTVPET-CT分别为(288.6±52.1)、(312.4±79.4)cm3,差异均有统计学意义(P<0.05);其中6例患者GTV体积增大明显(超过20%),平均增大36.5%。PET-CT改变放疗计划参数:给予相同的靶区剂量60Gy/30次,基于PET-CT制定的放疗计划与基于CT制定的放疗计划相比,周围正常组织受量均发生相应变化,但差异无统计意义。结论应用PET-CT融合图像,可在保证正常组织受量符合临床要求的前提下,较精确地确定胰腺癌放射治疗靶区,利于制定合理的三维适形放疗计划,但相关结论仍有待进一步大样本研究证实。
Objective To investigate the value of positron emission tomography and computer tomography（PET-CT）in determining the target volume for three-dimensional conformal radiotherapy（3D-CRT）of locally advanced pancreatic carcinoma（LAPC）,so as to lay a foundation for PET-CT-based precision radiotherapy.Methods The target volume for 13confirmed LAPC patients who were referred for radical radiation therapy were delineated on both CT imaging and PET-CT fused imaging.The gross tumor volume（GTV）,clinical target volume（CTV）,planned target volume（PTV）,and received doses in the normal tissues were compared between the two images produced by the two methods.Results PET-CT image altered GTV and PTV on CT images.For all the 13 patients,the GTVCTversus GTVPET-CTwas（57.3±22.9）cm3 versus（68.4±31.7）cm3,CTVCTversus CTVPET-CT was（119.9±38.7）cm3 versus（132.7±47.5）cm3,and PTVCTversus PTVPET-CT was（288.6±52.1）cm3 versus（312.4±79.4）cm3,with significant difference found for all the three parameters（P0.05）.GTV of 6patients was increased by more than 20%,with an average increase of 36.5%.PET-CT image changed the parameters of dose-volume histograms（DVH）.When delivering the same target dose of 60Gy in 30 fractions,received doses in the normal tissues were different for the two plans created by the two methods,but showing no statistical significance.Conclusion PETCT fused imaging can accurately delineate the target volume for 3D-CRT of LAPC while keeping the received doses in the normal tissues within clinically acceptable level,which can help to create better 3D-CRT,but further conclusion still needs larger sample studies.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2014年第7期791-795,共5页
Academic Journal of Second Military Medical University
