CT/MRI图像融合技术引导的调强放疗对鼻咽癌患者靶区平均勾画体积及正常组织受量的影响

Effect of intensity modulated radiotherapy guided by CT/MRI image fusion technology on average delineated volume of target area and dose of normal tissues in patients with nasopharyngeal carcinoma

目的探讨CT/磁共振成像(MRI)图像融合技术引导的调强放疗对鼻咽癌患者靶区平均勾画体积及正常组织受量的影响。方法本研究为前瞻性研究。抽取2019年1月至2021年12月鹤煤总医院收治的80例鼻咽癌患者为研究对象,依照随机数字表法将其分为对照组和观察组,每组40例。所有患者均接受调强放疗,其中对照组患者利用CT定位扫描成像勾画放疗靶区,观察组患者利用CT/MRI图像融合技术勾画放疗靶区。记录并对比所有患者靶区勾画体积、正常组织受量、治疗效果、不良反应发生情况。结果对照组靶区平均勾画体积为(38.65±17.12)cm^(3),观察组为(47.34±17.96)cm^(3),差异有统计学意义(t=2.22,P=0.030)。观察组治疗总有效率(52.50%,21/40)高于对照组(27.50%,11/40),P<0.05。观察组脑干、咽喉、视神经、腮腺、脊髓、甲状腺、内耳正常组织受量均少于对照组(P均<0.05)。两组患者治疗后不良反应发生情况比较差异未见统计学意义(P>0.05)。结论CT/MRI图像融合技术引导的调强放疗可精确鼻咽癌患者靶区平均勾画体积,减少正常组织受量,提高治疗效果。

Objective To investigate the effect of intensity modulated radiotherapy(IMRT)guided by computed tomography(CT)/magnetic resonance imaging(MRI)image fusion technology on the average delineated volume of target area and the dose of normal tissues in patients with nasopharyngeal carcinoma.Methods This study was a prospective study.Eighty nasopharyngeal carcinoma patients admitted to Hebi Coal General Hospital from January 2019 to December 2021 were selected as the research subjects.According to the random number table method,they were divided into control group and observation group,with 40 cases in each group.All patients received IMRT.The patients in the control group used CT localization scanning imaging to delineate the radiotherapy target,and the patients in the observation group used CT/MRI image fusion technology to delineate the radiotherapy target.The average delineated volume of target area,dose of normal tissue,therapeutic effect and adverse reactions of all patients were recorded and compared.Results The average delineated volume of target area in the control group was(38.65±17.12)cm^(3),and that in the observation group was(47.34±17.96)cm^(3),the difference was statistically significant(t=2.22,P=0.030).The total effective rate of the observation group(52.50%,21/40)was higher than that of the control group(27.50%,11/40),P<0.05.The dose of normal tissues in brain stem,pharynx and larynx,optic nerve,parotid gland,spinal cord,thyroid gland and inner ear in the observation group were less than those in the control group(P<0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups after treatment(P>0.05).Conclusions IMRT guided by CT/MRI image fusion technology can accurately delineate the average target volume of nasopharyngeal carcinoma patients,reduce the dose of normal tissue,and improve the therapeutic effect.