食管癌三维适形常规分割放疗过程中肿瘤体积变化规律的临床探究与分析

The esophageal tumor volume changes in 3DCRT with conventional fraction

目的 通过对食管癌肿瘤体积的检测,研究在使用三维适形常规分割放疗对食管癌患者进行治疗时,其肿瘤大小的变化情况。方法 选取食管癌患者6例,所有患者均行常规分割根治性三维适形放射对食管癌进行治疗。在治疗过程中,分别在治疗的第2、4和6周以及放疗结束后2个月内采用彩色增强扫描CT机观察不同时期CT图像,并通过图像处理计算肿瘤体积变化情况。结果 行根治性三维适形常规放射治疗后显效率50.0%,总有效率83.3%。所有食管癌患者在放疗过程中（0∽14周）肿瘤体积逐渐减小,肿瘤体积变化符合指数衰减趋势模式,消退常数分别为0.2020、0.4139、0.2390、0.1516、0.1317和0.1416,对应的半衰期为35.76、24.80、27.36、43.95、49.41和47.83d。结论 通过食管癌放疗体积变化的临床实验,可减少治疗过程中肿瘤体积的变化对肿瘤放疗的影响,弥补肿瘤体积变化带来的治疗误差,从而显著提高了放疗的短期临床疗效。

[ Objective] To observe and analyze the principal of esophageal tumor volmne changes in 3DCRT with conventional fraction. [Methods] This study was performed on 6 patients with esophageal cancer who were treated with radical three-dimensional conformal radiotherapy. Thoracic contrast-enhanced CT scan was performed-during early second weekend, forth weekend, sixth weekend and 1 month after RT completion. Image software was used to calculate tumor volume. [ Results ] In the course of radiotherapy （0-14 weeks）, tumor volmne in all patients with esophageal changed with the exponential trend model, and the regression constants were 0.2020, 0.4139, 0.2390, 0.1516, 0.1317, 0.1416, and the corresponding half-life were 35.76 d, 24.80 d, 27.36 d, 43.95 d, 49.41 d, 47.83 d , respectively. [ Conclusion ] The treatment of esophageal tumor volume changes in 3DCRT with conventional fraction can reduce the volume effect on tumor radiotherapy treatment, and make up for the error caused by the change in tumor volume, which can also significantly improve the short-term clinical effect.