不同体位固定技术对肺癌靶区勾画体积及危及器官所受照射剂量的影响

Effects of Different Position Fixation Techniques on the Volume of the Target Area of Lung Cancer and the Dose of Exposure to the Organs Endanger

目的探讨不同体位固定技术对肺癌靶区勾画体积及危及器官所受照射剂量产生的影响作用。方法将收治的肺癌患者69例作为对象进行研究,所有患者分别使用真空垫+辅助人工腹带固和热塑体膜固定,对比观察患者使用不同体位固定技术进行CT定位,图像重建后由一名专业的医生进行靶区勾画,根据结果进行相应的治疗,并比较在不同体位下患者靶区勾画体积和危及器官受照射剂量。结果结果显示使用真空垫+人工腹带进行固定后患者勾画的GTV、CTV和PTV体积均明显小于热塑体膜固定,脊髓最大照射剂量、肺部V5和V20等剂量也均明显低于热塑体膜固定(P <0. 05)。结论使用真空垫+人工腹带对肺癌靶区勾画体积效果要明显优于热塑体膜固定,同时可减少对患者危及器官所受的最大照射剂量,效果显著,条件允许的情况下可在临床范围内推广使用。

Objective To investigate the effect of different fixation techniques on the delineation volume of lung cancer target and the dose of exposure to organs. Methods 69 patients with lung cancer were selected.All patients were treated with vacuum pad and assisted artificial abdomen banding and thermoplastics,and the patients were compared with each other Position fixation technique CT positioning,the image reconstruction by a professional doctor after the target area outlined,according to the results of the corresponding treatment,and compare the volume of the patient target in different positions outlined and at risk of organ irradiation dose. Results The volumes of GTV,CTV and PTV delineated by patients with vacuum cushion and artificial abdomen was significantly less than that of the thermoplast.The maximum radiation dose of the spinal cord and the doses of V5 and V20 in the lung were also significantly lower than those of the thermoplast Fixed （ P〈0.05）. Conclusion The volumetric effect of vacuum pad ＋ artificial abdomen on lung cancer target area is obviously better than that of thermoplastics membrane,meanwhile it can reduce the maximal irradiation dose to organ endangered patients,and the effect is obvious.If the conditions permit,Promotion should be within the scope of use.