CT扫描在食管癌放疗中作用的探讨

Study on Action of CT in Radiotherapy for Esophagus Carcinoma

目的:探讨食管癌浸润规律及CT在食管癌放疗设野中的作用。方法:先在模拟定位机下初步定位,再标记后行CT检查,测量肿瘤外浸情况,并根据CT结果判断初定照射野的合适程度,不合适者在模拟定位机下重新定位。结果:肿瘤左右浸润不对称占44.8％(52/116),前后浸润不对称占20.7％(24/116),6cm宽的照射野不能包全肿瘤有47例(40.52％)。结论:食管钡餐不能了解肿瘤的外浸情况,单纯以食管中心设置6 cm宽的照射野,不能满足放疗的需要。食管癌的放疗定位需借助CT检查,CT检查在食管癌的放疗中不可省略。

Objective: To study the invaded pattern of esophagus carcinoma and the action of CT in confirm portals. Method: Simulated the fields first, putted markers on skin and then perform CT scan. Measure sizes of tumor and judge the fields if comfort to tumor. Simulated the fields again for those not comfort to tumor. Results: 44.8% of the tumor is asymmetrical in horizontal, 20.7% is asymmetrical in vertical, fields with 6 cm wide cannot cover the whole tumor in 47 cases (40.5%). Conclusions: Esophagogram doesn't give enough infonnation on the invaded of the carcinoma. It doesn't satisfy need of radiotherapy if the portals were simply set as a 6 cm wide area centered at the center of esophagus. The CT scan is needed in the positioning of radiotherapy of esophagus carcinoma to facilitate the evaluation of the properness of field. CT exam cannot be omitted in the radiotherapy of esophagus carcinoma.