食道癌精确放疗的临床应用及影像学表现

Clinical application and the imaging representation of T2000-ROT accurate location system for esophageal carcinoma

目的分析T2000-ROT食道癌精确定位系统的临床应用及放疗后的影像学改变。方法采用带有N形标记柱的体部框架,内加真空负压垫。对病人身体进行固定和重复固定,服稀钡或泛影葡胺造影后,以3 mm或5mm层厚进行CT断层扫描,将病人图像数据传输到3DTPS,通过CT图像信息以及标记点,计算出肿瘤的三维坐标。根据现有的长方形旋转照射野剂量模型,计算某一照射方案下体模中任意一点的剂量值及横断面上的等剂量分布。利用直线加速器对病人实施治疗。结果利用该系统治疗160例经DR或CT确诊并经病理证实为食道癌病人,有效研究病例114例,治疗后1年和3年局部控制率为96.5%和86.8%;经CT或DR检查病变消失,食道恢复正常者分别为75%和75.4%,管壁显示僵硬、蠕动减弱者为22.5%和11.4%;局部复发为2.5%和13.2%。结论T2000—ROT食道癌精确放疗系统,定位精确,能够使高剂量区均匀准确分布于病灶及亚临床灶区,杀灭肿瘤病灶,使食道恢复正常形态和功能,有效提高局部控制率。

Objective： To analyze the clinical application of T2000 -ROT accurate location system for esophageal carcinoma and the imaging changing of it. Materials and methods ： The body frame structure with ＇N＇pole signed is adopted and added a vacuum pad inwards. Later the patient was fixed and reaffixed in the phantom, then was imaged by 3 mm or 5 mm CT after the patient swallowed BaSO4 or diatrizoate meglumine angiografin. The image was sent to3 - D TPS by net. Based on the CT image and markers, the 3 - D coordinate of carcinoma is calculated. According to current dose model of radiation field, any spot dose and any dimensional dose distribution are calculated in the phantom when a radiation scheme is given. The patient is treated by the linear accelerator. Result： There were 160 patients who were confirmed suffering from esophageal carcinoma by CR or CT, 114 cases were in available. The local control rate is 96.5% in a year and 86.8% in three years when the patient is treated by this system. 75% were comeback in one year, the focus were disappear in the CR or CT image and there were 75.4 in three years. Esophagus ankylosis alleviated respective 22.5% and 11.4. Local recrudescent were 2. 5% and 13.2. Conclusion： T2000 - ROT accurate location system of esophageal carcinoma is a accurate location devise. It can make the dose accurately contributed to clinical target and sub - clinical target. And it advances the local control ratio.