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中国癌症防治杂志

中国癌症防治杂志 ›› 2013, Vol. 5 ›› Issue (3): 231-235.doi: 10.3969/j.issn.1674-5671.2013.03.09

• 临床研究 • 上一篇    下一篇

非小细胞肺癌化疗同期调强放疗靶区变化规律的临床分析

  

  1. 贵阳医学院附属医院/贵州省肿瘤医院胸部肿瘤科
  • 出版日期:2013-09-25 发布日期:2013-10-10
  • 通讯作者: 卢冰 E-mail:lbgymaaaa@sohu.com

Changes in tumor volume during intensity-modulated radiotherapy for non-small cell lung cancer

  • Online:2013-09-25 Published:2013-10-10

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被引次数

6

摘要： 目的 分析非小细胞肺癌（non-small cell lung cancer，NSCLC）调强放疗（intensity modulated radiotherapy，IMRT）过程中肿瘤体积动态变化的情况。方法25 例经病理学或细胞学检查诊断为NSCLC 的患者接受IMRT，分别于放疗前、放疗20 Gy、30 Gy、40 Gy、50.5 Gy、61 Gy 时予以螺旋CT 模拟定位扫描检查，在各次CT 扫描上勾画原发肿瘤（GTV）和纵隔转移淋巴结（GTVnd），并分析其变化规律。结果 随放疗剂量的增加，GTV和GTVnd 的体积逐渐缩小，放疗40 Gy 后肿瘤缩小的速度逐渐缓慢，选择放疗40 Gy 时肿瘤体积与放疗前肿瘤体积进行比较，GTV（t=5.019, P=0.000）和GTVnd（t=5.267，P=0.000）体积缩小的差异有统计学意义。以中位值为分界点，GTV≥101.45 cm3、GTV＜101.45 cm3、GTVnd≥50.35 cm3 和GTVnd＜50.35 cm3 放疗40 Gy 后肿瘤体积缩小的速度逐渐缓慢，与放疗前肿瘤体积缩小比较差异均有统计学意义（t=6.019，P=0.000 ；t=6.491，P=0.000；t=5.449，P=0.000 ；t=7.919，P=0.000）。大体积肿瘤缩小更快、更明显。结论 随着放疗剂量的增加，肿瘤体积逐渐缩小，放疗40 Gy 后肿瘤体积缩小的速度逐渐缓慢，大体积肿瘤比小体积肿瘤缩小更快、更明显。

关键词: 肺肿瘤, 非小细胞肺癌, 调强放疗, 肿瘤体积, 变化

Abstract: Objective To analyze changes in target tumor volume during intensity-modulated radiotherapy（IMRT）for non-small cell lung cancer（NSCLC）. Methods A total of 25 NSCLC patients underwent IMRT.With the following dose series（Gy）:20，30，40，50.5 and 61，simulation computed tomography scans were carried out before each treatment to measure changes in gross tumor volume（GTV）and gross target volume of mediastinal nodes（GTVnd）. Results Both GTV and GTVnd decreased over the course of IMRT.The lowest dose causing significant changes from baseline was 40 Gy：GTV，t=5.019，P=0.000；GTVnd，t=5.267，P=0.000.IMRT was associated with significant decreases in GTV and GTVnd even after patients were grouped according to initial tumor volumes：GTV≥101.45 cm3，t=6.019，P=0.000；GTV＜101.45 cm3，t=6.491，P=0.000；GTVnd≥50.35cm3，t=5.449，P=0.000；GTVnd＜50.35 cm3 ,t=7.919，P=0.000.However，volume changes were greater for larger tumors than for smaller ones. Conclusions GTV and GTVnd gradually decreased over the course of IMRT，with larger tumors showing greater decreases. Significant decreases in GTV and GTVnd occurred even after treatment at 40 Gy.

Key words: Lung neoplasms, Non-small cell lung cancer, Intensity-modulated radiotherapy, Tumor volume, Change