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兆伏级锥形束CT在鼻咽癌调强放射治疗中的临床应用研究 被引量：9

Application Study of Megavolt Cone-beam Computed Tomography to Intensity-modulated Radiotherapy of Nasopharyngeal Carcinoma
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摘要 目的评估兆伏级锥形束CT(CBCT)图像引导鼻咽癌调强放射治疗(IMRT)摆位误差和计划靶体积(PTV)的边界。方法采用头颈肩热塑体膜固定体位,对22例鼻咽癌患者设计IMRT逆向调强放疗计划,采用西门子ONCOR直线加速器配备的MVision兆伏级CBCT容积成像并与计划CT图像进行三维方向(左右、头脚、前后)匹配,获取前5次放射治疗摆位误差调整前和调整后的CBCT数据,分析摆位误差及PTV外扩边界。结果 22例患者三维方向摆位误差分别为左右(-0.03±1.68)mm、头脚(0.17±2.03)mm和前后(0.28±2.15)mm。摆位误差调整后与调整前相比在三维方向均有降低,并且有统计学差异(P<0.05)。5次CBCT分次间摆位误差在三维方向上均无统计学差异(P>0.05)。摆位误差调整前PTV外扩边界,左右2.78mm,头脚3.22mm,前后3.46mm。摆位误差调整后PTV外扩边界,左右1.74mm,头脚1.94mm,前后2.13mm。结论鼻咽癌各个方向的计划靶区边界小于4mm,采用兆伏级CBCT技术对鼻咽恶性肿瘤IMRT治疗分次间摆位误差的纠正和PTV边界的评估对提高鼻咽癌IMRT治疗的精度有重要意义。 Objective To evaluate the interfractional three-dimensional（3D）setup error and propose optimum margin of planning target volume（PTV）in radiotherapy for nasopharyngeal carcinoma at risk using intensity modulated radiotherapy（IMRT）guided with cone-beam computed tomography（CBCT）.Methods Twenty two cases of patients received radiotherapy of IMRT imaging-guided with megavolt MVision CBCT scans equipped in ONCOR Linear Accelerator.The initial five fractional CBCT volume-imaging and data obtained by CBCT scans after initial setup and after re-positioning were dimensionally matched with planned CT image.Results The interfractional setup errors on X,Y and Z axes were（-0.03±1.68）mm,（0.17±2.03）mm and（0.28±2.15）mm,respectively,for 22 nasopharyngeal carcinoma.Comparing with the pre-correction position,the post-correction setup errors decreased significantly on all three axes（P〈0.05）,whereas there were no statistically significant differences in five fractional setup errors（P〉0.05）.While without correction of CBCT setup errors,PTV margin in three dimension were La（tcm）-X：2.78 mm,Long（cm）-Y：3.22 mm,Ver（tcm）-Z：3.46 mm.while with correction of CBCT setup errors,PTV margin in three dimension were Lat（cm）-X：1.74 mm,Long（cm）-Y：1.94 mm,Vert（cm）-Z：2.13 mm.Conclusion The set-up margins were less than 4 mm in all directions.Measurement and correction of interfractional setup errors and PTV margins before fractional radiotherapy using megavolt MVision CBCT could help to improve the precision of IMRT radiotherapy for nasopharyngeal carcinomas.
作者 韩琤波 贾明轩 张旭 邹华伟
机构地区 中国医科大学附属盛京医院第一肿瘤科
出处 《中国医科大学学报》 CAS CSCD 北大核心 2010年第8期635-638,共4页 Journal of China Medical University
基金 国家自然科学基金资助项目(30700979)
关键词 鼻咽癌 调强放射治疗 锥形束CT 摆位误差 图像引导 nasopharyngeal carcinoma intensity modulated radiotherapy cone-beam computed tomography setup errors image guided radiotherapy
分类号 R730.55 [医药卫生—肿瘤]
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参考文献16

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二级参考文献20

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共引文献14

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引证文献9

二级引证文献120

中国医科大学学报
2010年 第8期

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