CT截断区域对食管癌患者放疗计划剂量学影响

doi:10.13491/j.issn.1004-714X.2022.06.015

中国辐射卫生

2022, Vol. 31

Issue (6): 724-730 DOI: 10.13491/j.issn.1004-714X.2022.06.015

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CT截断区域对食管癌患者放疗计划剂量学影响

谢凯^1,2, 张恒², 奚谦逸², 张钒², 张赛², 高留刚^1,2, 孙佳伟^1,2, 林涛^1,2, 眭建锋^1,2, 倪昕晔^1,2

1. 南京医科大学附属常州第二人民医院放疗科，江苏常州 213000;
2. 江苏省医学物理工程研究中心/南京医科大学医学物理中心实验室/常州市医学物理重点实验室，江苏常州 213000

Dosimetric effect of CT truncated regionson radiotherapy for thoracic esophageal cancer

XIE Kai^1,2, ZHANG Heng², XI Qianyi², ZHANG Fan², ZHANG Sai², GAO Liugang^1,2, SUN Jiawei^1,2, LIN Tao^1,2, SUI Jianfeng^1,2, NI Xinye^1,2

1. Department of Radiotherapy, Nanjing Medical University Affiliated Second People’s Hospital of Changzhou, Changzhou 213000 China;
2. Jiangsu Province Engineering Research Center of Medical Physics/Center for Medical Physics Nanjing Medical University/Key Laboratory of Medical Physics, Changzhou 213000 China

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摘要目的探讨CT图像截断区域对胸中段食管癌容积调强计划（VMAT）中靶区和危及器官的剂量学影响。方法选取15例胸中段食管癌患的CT图像，设置圆形掩膜使得截断区域体积占手臂体积的10%、20%、30%和40%，得到相应的截断CT，真实CT记为CT0。在CT0上制作2组放疗计划，一组为采用全弧的VMAT_1F，一组为采用避开手臂的三弧VMAT_3F，并将计划复制至4种截断CT。使用Wilcoxon符号秩检验比较不同计划的剂量学差异。结果与CT0中VMAT_1F相比，CT0中VMAT_3F降低肺的D_mean和V₅，但增加了脊髓的D_max、心脏的D_mean和肺的V₂₀。VMAT_3F中，4种截断CT中的剂量学参数与CT0中的没有统计学差异（均P > 0.05）。VMAT_1F中，除均匀性指数HI和脊髓D_max外，4种截断CT中的剂量学参数与CT0中的均有统计学差异（P < 0.05），且剂量学差异随着截断区域体积比的增加而增大。结论临床中应采集完整的CT数据，必要时设置避开截断区域的射野，降低其对剂量学的影响。

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	谢凯
	张恒
	奚谦逸
	张钒
	张赛
	高留刚
	孙佳伟
	林涛
	眭建锋
	倪昕晔

关键词 ：食管癌, 容积旋转调强放疗, 截断CT, FOV, 剂量学参数

收稿日期: 2022-04-18

PACS:

R861

基金资助:常州市应用基础研究（CJ20200099，CJ20210128）；常州市卫健委青苗人才（CZQM2020075，CZQM2020067）；江苏省医学物理工程研究中心项目（苏发改高技发（2021）1368号）；江苏省卫健委面上项目（M2020006）

通讯作者: 倪昕晔，E-mail：nxy@njmu.edu.cn E-mail: nxy@njmu.edu.cn

作者简介: 谢凯（1990—），男，安徽安庆人。助理研究员，从事放射治疗工作。E-mail：229623265@qq.com

引用本文:

谢凯, 张恒, 奚谦逸, 张钒, 张赛, 高留刚, 孙佳伟, 林涛, 眭建锋, 倪昕晔. CT截断区域对食管癌患者放疗计划剂量学影响[J]. 中国辐射卫生, 2022, 31(6): 724-730.
XIE Kai, ZHANG Heng, XI Qianyi, ZHANG Fan, ZHANG Sai, GAO Liugang, SUN Jiawei, LIN Tao, SUI Jianfeng, NI Xinye. Dosimetric effect of CT truncated regionson radiotherapy for thoracic esophageal cancer. Chinese Journal of Radiological Health, 2022, 31(6): 724-730.

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