【摘要】 [目的]观察非小细胞肺癌(NSCLC)三维适形放疗(3D-CRT)中增强CT定位对放疗计划参数的影响。[方法]对97例在CT定位下拟行根治性3D-CRT的NSCLC患者,分别以CT平扫图像、增强CT图像勾画大体肿瘤靶区(GTVCT和GTVCT+),分别制定放疗计划。[结果]增强CT明显改变35例(36.1%)患者PTV和/或GTV。增强CT组与平扫CT组的计划参数GTV的体积(VGTV)、受照射量≥45Gy的食管占全食管体积的比例(VE45)和脊髓最大受照射剂量(SCM)差异有统计学意义(P均<0.001)。[结论]利用增强CT定位能更加准确地确定靶区,据此制定3D-CRT可更优的覆盖靶区,降低脊髓、食管的受照射剂量。更多还原

【Abstract】 [Purpose] To investigate the effect of contrast-enhanced CT and on the three-dimensional conformal radiotherapy(3D-CRT) treatment planning parameters in patients with non-small cell lung cancer(NSCLC).[Methods] Contrast-enhanced CT was performed in 97 pathologically proven NSCLC patients for radical radiotherapy.The gross tumor volume(GTV) was initially delineated on the CT images(GTVCT),and the corresponding contrast-enhanced,CT data were subsequently used to delineate the target volume(GTVCT+).3D-CRT plans were made according to different target volume.[Results] Contrast-enhanced CT clearly altered the radiation therapy volume(PTV/GTV) in 35 patients(36.1%).Between the contrast-enhanced CT and plain CT radiotherapy planning,differences of indexes including volume of GTV(VGTV),esophageal volume receiving at least 45Gy(VE45),the maximum dose of spinal cord receiving(SCM) were all with statistically significant(P all<0.001).[Conclusions] The volume is more accurately determined by contrast-enhanced CT.3D-CRT treatment planning accord to contrast-enhanced CT may coverage the target better,and reduce the dose of spinal cord and esophageal更多还原