食管癌CT模拟定位放疗初探

Primary study on the three-dimensional imitated orientation CT scan in the radiotherapy of esophageal carcinoma

目的 探讨CT模拟定位技术对放射治疗食管癌的作用。方法 1997年至 1999年经病理证实的 62例中晚期食管癌 ,根据CT扫描所获得的不同影像资料 ,在工作站上经计算机数字化处理 ,建立三维模拟“假体” ,进行放射照射野的定位设计。结果 62例病变食管壁增厚 ;肿瘤形态不规则 48例 ,占 77.4% ;肿瘤偏侧性生长 45例 ,占 72 .5 %。肿瘤侵犯气管 17例 ,占 2 7.4% ;侵犯血管 3例 ,占 4.8% ;淋巴结转移 15例 ,占 2 4.2 %。以肿瘤为射野中心 ,灵活选择与肿瘤形态大小、外侵情况、淋巴结转移相对应的照射野设计。结论 食管癌CT模拟定位准确 ,照射野选择合理 ,治疗效果令人满意 ,具有广阔的发展前景。

Objective To evaluate the function of imitated orientation CT scan in the radiotherapy of esophageal carcinoma.Methods From 1997 to 1999,62 patients with pathologically proved esophageal cancer were studied.The irradiation portals were designed through computer digital processing in the workstation and the three dimensional imitated'pseudobody'was set up on the different imaging data obtained through CT scan.Results The esophageal wall was thickened in 62 patients;the shape of the tumor was irregular in 48 patients(77.4%);the tumor located at one side in 45 patients(72.5%).The trachea was invaded in 17 patients(27.4%);the vessel was involved in 3 patients(4.8%);the lymph node metastasized in 15 patients(24.2%).Taking the tumor as the center field,the field was designed according to the shape and the size of the tumor,the area of the invasion and lymph node metastasis.Conclusion The imitated orientaion CT scan is accurate and the irradiation field can be chosen rationally.The therapeutic effects are satisfactory and its uses are potential.