锥形束CT配准前后的肺癌调强放疗计划的临床研究

目的比较配准前后锥形束CT的肺癌调强放疗计划。方法选择22例肺癌患者为研究对象,患者每周1次CBCT扫描(行治疗前、治疗后扫描),对比校正前后各参数指标。结果 CBCT校正后的PTV体积有优势(P<0.05),其他指标校正前后均相似(P>0.05)。CBCT校正后的双肺平均剂量有优势(P<0.05),而脊髓最大剂量校正前后相似(P>0.05)。CBCT校正前后,双肺V5、V10、V20、V30、V50等指标均相似(P均>0.05)。校正后NTCP随V5、V10、V20升高有降低趋势(P=0.152、0.048、0.000)。结论经CBCT校正后的放疗计划可有效减少NTCP,增加PTV剂量,提高放疗效果,且安全性较高,可提升肺癌的治疗效果。

Comparison of Intensity-modulated Radiotherapy Plan of Cone Beam CT before and after the Registration of Lung Cancer

Objective To study intensity-modulated radiotherapy plan of cone beam CT before and after the registration of lung cancer. Methods Totally 22 patients with lung cancer were selected as the research object. Patients got CBCT scan 1 times a week (line scan before and after treatment). The parameters before and after the correction were compared. Results PTV volume had advantages of CBCT adjusted (P<0.05), and other indicators before and after correction were similar (P>0.05). Mean dose of CBCT had advantages after correction of the double lung (P<0.05), whereas the spinal cord before and after the maximum dose correction was similar (P>0.05). CBCT before and after correction, the double lung V₅, V₁₀, V₂₀, V₃₀, V₅₀ and other indicators were similar (P>0.05). After correction, NTCP with increasing V₅, V₁₀, V₂₀ had a tendency to reduce (P=0.152, 0.048, 0.000). Conclusion Radiotherapy plan after the correction of CBCT can effectively reduce NTCP, increase the PTV dose, improve the effect of radiotherapy, and has high safety, and it can improve the therapeutic effect of lung cancer.