
1. (浙江大学医学院附属第二医院放疗科 ),杭州,310009
[ "朱小杨,女,1979年9月出生,2004年于浙江大学获生物物理学硕士,工程师,Email: zxy2609@sohu.com" ]
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朱小杨. 老年非小细胞肺癌肺复张后的二次IMRT研究[J]. 辐射研究与辐射工艺学报, 2012,30(4):227-230.
朱小杨. 老年非小细胞肺癌肺复张后的二次IMRT研究[J]. 辐射研究与辐射工艺学报, 2012,30(4):227-230. DOI: 10.11889/j.1000-3436.2012.rrj.30.120407.
摘要 本研究以探讨老年非小细胞肺癌(NSCLC)在调强放疗(IMRT)期间,其患侧肺的复张对受照体积及其计划剂量参数的影响。选择了15例Ⅱ-Ⅳ期老年NSCLC合并肺不张患者,以放疗前(CT1)和放疗32 Gy时(CT2)扫描的CT图像为依据,分别设计调强计划P60和 P32+P28。结果发现:CT2-GTV(Gross tumor volume,CT2上的大体肿瘤体积,其他同)和CT2-PTV(Planned target volume,CT2上的计划靶区,其他同)的平均受照体积,显著低于CT1-GTV和CT1-PTV,而CT2-Lung患侧的平均体积则较CT1-Lung患侧有了显著增加,结果有统计学意义(p<0.05)。除了食管V50(接受50 Gy剂量的食管体积,%)外,实验中其余正常组织的各项受照剂量指标间差异均有统计学意义(p<0.05)。因此老年NSCLC合并肺不张患者,在放疗32 Gy后,即有必要复查肺是否已复张,并重新设计IMRT计划,使得老年NSCLC患者在肺复张后的心肺受照剂量更低。
This study is to evaluate the effects of recruitment maneuvers on the irradiated volume and absorbed doses during the intensity-modulated radiation therapy (IMRT) with elderly patients with non-small cell lung cancer (NSCLC). 15 elderly patients suffered fromⅡ–Ⅳ class NSCLC with atelectasis were selected for this study. Based on the result of CT images before (CT1) and after irradiation with 32 Gy (CT2), each patient was given 2 IMRT plans (P60 and P32+P28). The changes of target and normal organs were evaluated again. The results showed that the average volumes of CT2-GTV and CT2-PTV were significantly lower than those of CT2-GTV and CT1-PTV, but the volume of CT2-Lungsuffered lung was increased significantly than that of CT1-Lungsuffered lung (p<0.05). The absorbed doses index of other normal organs showed significant differences between two plans (p<0.05). According to the atelectasis in elderly patients with NSCLC, it is necessary to make the CT scan again and design a new IMRT plan after irradiation with 32 Gy, which makes the lung and heart of elderly patients with NSCLC get lower radiation burden after recruitment maneuvers.Cited
老年非小细胞肺癌肺复张二次IMRT
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