对术后局部复发的食管癌患者进行调强放疗时用内镜下肽夹定位技术勾画其放疗靶区的效果

Endoscopically located peptide clip technique was used to delineate the radiotherapy target area of locally recurrent esophageal cancer patients undergoing imrt

目的:探讨对术后局部复发的食管癌患者进行调强放射治疗(放疗)时用内镜下肽夹定位技术勾画其放疗靶区的效果。方法:将近年来在扬州大学附属医院接受调强放疗的30例术后局部复发的食管癌患者作为研究对象。在进行调强放疗前,分别采用综合影像定位技术和内镜下肽夹定位技术为这些患者勾画放疗靶区,然后比较用这两种技术勾画放疗靶区时其肿瘤靶区(GTV)的长度、临床靶区(CTV)的体积及其不良反应的发生率,同时比较用这两种靶区勾画技术为其勾画放疗靶区后对其进行调强放疗时其靶区及危及器官的照射剂量。结果:与用综合影像定位技术为这30例患者勾画放疗靶区相比,用内镜下肽夹定位技术为其勾画放疗靶区时其GTV的长度更短、CTV的体积更小,P<0.05。与用综合影像定位技术为这30例患者勾画放疗靶区后对其进行调强放疗相比,用内镜下肽夹定位技术为其勾画放疗靶区后对其进行调强放疗时其肺V5、肺V20、心脏和脊髓的照射剂量均更小,P<0.05。用综合影像定位技术和内镜下肽夹定位技术为这30例患者勾画放疗靶区后其不良反应的发生率相比,P>0.05。结论:对术后局部复发的食管癌患者进行调强放疗时,用内镜下肽夹定位技术勾画其放疗靶区能显著提高其放疗靶区勾画的精准度,减少放疗时其靶区及危及器官的照射剂量。

objective:to investigate the effect of intensity modulated radiotherapy(radiotherapy)on delineating the radiotherapy target area with endoscopic peptide clamp positioning technique in patients with postoperative local recurrence of esophageal cancer.Methods:in recent years,30 patients with local recurrence of esophageal cancer who received imrt in the affiliated hospital of yangzhou university were studied.Before undergoing intensity-modulated radiotherapy,adopt the comprehensive image positioning technology and endoscopic peptide clamp positioning technology sketch radiotherapy target areas for these patients,then compared with the two technical sketch target zone the tumor radiotherapy the length of the target area(GTV),clinical target volume(CTV)and the incidence of adverse reactions,and compare with the two target sketch technology for its outline after radiotherapy target when the intensity modulated radiation therapy(imrt)for its target and endanger the exposure dose of organs.Results:the length of GTV was shorter and the volume of CTV was smaller when the radiotherapy target was delineated by endoscopic-peptide localization technique,compared with that of the 30 patients,P<0.05.Compared with intensity modulated radiotherapy after delineating the radiotherapy target areas of the 30 patients with comprehensive imaging and positioning technology,the radiation dose of V5,V20,heart and spinal cord in the patients undergoing intensity modulated radiotherapy after delineating the radiotherapy target areas of the 30 patients with endoscope peptide positioning technology was smaller,P<0.05.The incidence of adverse reactions after delineating the radiotherapy target sites of the 30 patients by using comprehensive imaging and endoscopic peptide clip positioning technology was P>0.05.Conclusion:when intensity modulated radiotherapy is applied to patients with postoperative local recurrence of esophageal cancer,the delineation of the radiotherapy target area by endoscopic-peptide localization technique can significantly improve the accuracy of the delineation of the radiotherapy target area and reduce the radiation dose of the target area and organs at risk.