摘要
目的探讨四维放射治疗技术(4D-CT)重建技术在肝癌精确放疗定位的应用效果。方法分别采用三维放射治疗技术(3D-CT)和4D-CT对20例原发性肝癌患者进行扫描,在3D-CT上分别勾画靶区实体肿瘤靶区、临床靶体积、计划靶体积;在4D-CT上分别勾画内肿瘤靶区、靶区、计划靶体积。结果 4D-CT靶区体积为(148.15±92.04)cm3,3D-CT靶区体积为(249.52±136.51)cm3,两者差异有统计学意义(P<0.05);4D-CT和3D-CT靶区中心在X、Y、Z轴的位移差异无统计学意义(P>0.05);4D-CT的MDTNL、V30、NTCP分别为(18.81±3.89)Gy、(30.21±7.30)%、(12.72±9.27)%,明显高于3D-CT的(14.59±4.47)Gy、(22.95±9.28)%、(6.46±6.69)%,差异均有统计学意义(P<0.05)。结论 4D-CT技术能准确记录肿瘤随呼吸运动的移动轨迹,精确定位放射治疗靶区位置,从而利于个体化确定靶区体积,避免靶区丢失,减少外扩范围,避免过度照射,可有效降低肝脏NTCP,提高靶区剂量,提高放疗疗效。
Objective To investigate the effect of 4D-CT reconstruction technique in accurate radiotherapy for hepatocellular carcinoma. Methods Twenty patients with hepatocellular carcinoma were scanned by 4D-CT and 3D-CT,respectively. The target area,clinical target volume,target volume were delineated on 3D-CT,and the target volume was delineated on 4D-CT. Results The volume of 4D-CT target region was（ 148. 15 ± 92. 04） cm3,and the volume of3D-CT target region was（ 249. 52 ± 136. 51） cm^3,there was significant difference between the 4D-CT and 3D-CT target region（ P 〈0. 05）; There was no significant difference in（ X,Y,and Z） axis between the 4D-CT and 3D-CT target region（ P 〉0. 05）; MDTNL,V30,NTCP of 4D-CT were significantly higher than those of 3D-CT（ P〉 0. 05）. Conclusion 4D-CT technology can accurately record the trajectory of tumor with respiratory movement,accurately position the target area,to avoid the loss of target area,the individual to determine the target volume,reducing the scope of external expansion,to avoid partial normal liver tissue. It is not necessary to reduce the normal liver NTCP,improve the target dose and improve the effect of hepatocellular carcinoma radiotherapy.
出处
《胃肠病学和肝病学杂志》
CAS
2016年第8期885-888,共4页
Chinese Journal of Gastroenterology and Hepatology
