| 头颈部肿瘤VMAT治疗中靶区及腮腺的体积和剂量变化研究 |
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| 引用本文： | 陈星萌,余 璇,王亮和,昌 胜,李祥攀.头颈部肿瘤VMAT治疗中靶区及腮腺的体积和剂量变化研究[J].现代肿瘤医学,2022,0(15):2799-2803. |
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| 作者姓名： | 陈星萌 余 璇 王亮和 昌 胜 李祥攀 |
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| 作者单位： | 武汉大学人民医院肿瘤中心放疗科，湖北 武汉 430060 |
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| 摘 要： | 目的:探讨头颈部肿瘤患者在容积旋转调强放疗（volume modulated radiation therapy,VMAT）期间的解剖结构体积改变及剂量学变化。方法:选取8例头颈部鳞癌患者（口咽癌7例，喉癌1例），利用每日锥形束CT（CBCT）分析患者的靶区及腮腺体积随放疗时间的变化规律，并在放疗第10次和第22次再次进行定位CT扫描及计划设计，比较原计划与2次二程放疗计划中靶区、危及器官的剂量学变化。结果:所有患者的靶区及双侧腮腺体积随放疗的进行均呈缩小趋势，且双侧腮腺缩小较为明显。至放疗结束时，GTV和CTV体积退缩比率分别为 15.91%、11.58%；左右腮腺的退缩比率分别为29.72%、26.97%，P均<0.05。在2次二程放疗计划中靶区的D2、D98与脊髓、脑干的D1和原计划相比较差异均无统计学意义(P>0.05)，但左右腮腺照射剂量与放疗前相比均有所减少，差异均有统计学意义(P<0.05)。结论:头颈部肿瘤患者在VMAT期间靶区和腮腺体积均会显著缩小,放疗中期有必要设计二程放疗计划。采用离线自适应性放疗技术可提高靶区照射的准确性并在一定程度上降低腮腺的受照剂量。
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| 关 键 词： | 头颈部肿瘤 锥形束CT 腮腺体积 自适应放疗 |
Changes in volume and dosimetric of target and parotid gland during the head neck cancer volume modulated radiation therapy |
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| CHEN Xingmeng,YU Xuan,WANG Lianghe,CHANG Sheng,LI Xiangpan.Changes in volume and dosimetric of target and parotid gland during the head neck cancer volume modulated radiation therapy[J].Journal of Modern Oncology,2022,0(15):2799-2803. |
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| Authors: | CHEN Xingmeng YU Xuan WANG Lianghe CHANG Sheng LI Xiangpan |
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| Affiliation: | Department of Radiotherapy,Cancer Center,Renmin Hospital of Wuhan University,Hubei Wuhan 430060,China. |
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| Abstract: | Objective:To evaluate the changes in volume and dosimetric of target and organs at risk(OAR) during the head neck cancer volume modulated radiation therapy（VMAT）.Methods:Eight patients with head and neck squamous carcinoma were treated by VMAT in our institution.Daily cone beam CT(CBCT) image guidance and registration technology were applied to evaluated the anatomical changes of targets and parotid gland.Repositioning CT scanning and replanning for patients at radiotherapy 10th,22th times during radiotherapy.The change in volume and dosimetric of target and OAR were compared before radiotherapy and at radiotherapy 10th,22th times during radiotherapy of patients.Results:The volume of target and bilateral parotid gland were decreased with the progress of radiotherapy,and the bilateral parotid gland shrunk more obviously.To the end of radiotherapy,the volume of the GTV and CTV were narrowed 15.91% and 11.58% compared with that before radiotherapy,and the left and right parotid gland was narrowed 29.72% and 26.97%,respectively.The D2,D98 of target and D1 of spinal cord and brain stem in the new positioning CT showed no statistically significant differences between the 2 modified VMAT plan and before radiotherapy(P>0.05).Bilateral parotid irradiation doses were significantly decreased compared with those before radiotherapy(P<0.05).Conclusion:The volumes of target and parotid glands of head neck cancer patients showed significant shrinks during VMAT,replanning is necessary in the middle of VMAT.The use of offline adaptive radiotherapy technology can improve the accuracy of target coverage area and reduce the dose of irradiation of the parotid gland to a certain extent. |
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| Keywords: | head neck cancer CBCT parotid volume ART |
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