肝细胞癌放疗靶区勾画的研究进展

Research progress on target delineation for radiotherapy in hepatocellular carcinoma with

CT、MRI、PET-CT等现代影像学设备使肝细胞癌GTV的精确勾画成为可能,通过比较术后病理亚临床病灶、影像及临床指标等有助于CTV精确勾画,放疗辅助技术(如4DCT、腹部压迫、自主呼吸控制和呼吸门控等)可缩小ITV。真空袋和体膜固定可减小摆位误差,减小PTV和避免或减少照射误差。通过这些方法使肝细胞癌放射治疗的靶区缩小、剂量提升和并发症降低得以实现。本文就肝细胞癌外照射放射治疗靶区的研究进展作一综述。

Modern medical imaging techniques, such as computed tomorgraphy (CT), magnetic resonance imaging (MRI) and position emission tomorgraphy/computed tomorgraphy (PET-CT) can accurately delineate the gross target volume (GTV) of hepatocellular carcinoma (HCC). Comparison of postoperative pathological subclinical lesions, imaging and clinical parameters contributes to the precise delineation of clinical target volume (CTV). Moreover, radiotherapy-assisted techniques, such as four-dimensional computed tomography (4DCT), compression of abdomen, active breathing control and respiratory gating, can minimize the internal target volume (ITV). In addition, immobilization with vacuum cushion and body membrane can reduce the set-up error, minimize the planning target volume (PTV) and avoid or decrease the irradiation error or missing irradiation. All these approach can minimize the target volume, elevate the dose and reduce the complications during radiotherapy for HCC. In this article, the research progress on the target delineation for external beam radiotherapy in HCC patients was reviewed.