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PET-CT对晚期非小细胞肺癌精确放疗计划的影响

张芳   

  1. 中国人民解放军第254医院肿瘤中心
  • 收稿日期:2013-12-26 修回日期:2014-07-04 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 张芳

The Impact of PET-CT on Precise Radiotherapy Planning for Advanced Non-Small Cell Lung Cancer

ZHANG Fang   

  1. Department of Oncology, the 254thHospital of People’ s Liberation Army
  • Received:2013-12-26 Revised:2014-07-04 Published:2014-11-15 Online:2014-11-15
  • Contact: ZHANG Fang

摘要:

【摘要】 目的 探讨正电子发射计算机断层显像(PET-CT)对晚期非小细胞肺癌(NSCLC)靶区勾画及放疗计划的影响。 方法 30 例确诊的 NSCLC 患者进行 PET-CT 扫描, 分别以 CT 图像和 PET-CT 图像勾画肿瘤靶区GTV)并以相同参数制定放疗计划, 比较 2 套计划 GTV、计划靶区(PTV)和周围危及器官(OAR)的剂量变化。 结果 30 例患者中 PET-CT 融合图像上勾画的 GTV 及其相应 PTV 体积增大者有 8 例, 体积减小有 22 例。 PET-CT 图像改变了常规 CT 图像勾画的 GTV PTV 大小, 但在 PlanPET-CTPlanCT中的 VGTVVPTV之间的差异无统计学意义。 与
Planct比较, PlanPET-CT双肺 V20降低(P<0.05), 双肺 V30、平均全肺受照射剂量(MLD)及脊髓、食管、心脏的相关参数比较差异均无统计学意义。 结论 应用 PET-CT 勾画靶区可减少放射性肺炎的发生, 有利于提高靶区剂量。

关键词: 正电子发射断层显像术, 癌, 非小细胞肺, 放射疗法, 放射治疗剂量, PET-CT

Abstract: [Abstract]   Objective   To investigate the impact of PET-CT on the target volume delineation and precise radiothera?
py planning for patients with advanced non-small cell lung cancer (NSCLC).   Methods   PET-CT scanning was performed in 30 histologically proved NSCLC patients. The gross tumor volume (GTV) was delineated, and radiotherapy planning was established with identical parameters based on the CT image and PET-CT fused image, respectively. The differences of doses between GTV, planning target volume (PTV) and organsat rise (OAR) were compared.   Results   PET-CT image results changed the target volume delineation in 30 patients with 8 increased and 22 decreased. There were no differences in GTV and PTV between the VGTV and VPTV statistically, although PET-CT image changed conventional CT image size sketch of GTV and PTV. The V20 of total lung decreased in the PlanPET- CT compared with that of PlanCT (P < 0.05), but no differences were found in the V30 of total lung, mean lung dose (MLD), the data of spinal cord, esophagus and heart.   Conclusion   PET-CT may reduce the radiation injuries in the lung and improve the target dose.

Key words: positron- emission tomography, Carcinoma, Non-Small-Cell Lung, radiotherapy, radiotherapy dosage, PET-CT