QUANTIFICATION OF TUMOR VOLUME CHANGES DURING RADIOTHERAPY FOR NON-SMALL-CELL LUNG CANCER
QUANTIFICATION OF TUMOR VOLUME CHANGES DURING RADIOTHERAPY FOR NON-SMALL-CELL LUNG CANCER
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DOI：
10.1016/j.ijrobp.2008.07.063
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发表时间：
2009-06-01
影响因子：
7
通讯作者：
Song, Danny Y.
中科院分区：
文献类型：
--
作者：
Fox, Jana;Ford, Eric;Song, Danny Y.
目的：肺癌的剂量递增受正常组织毒性的限制。我们评估了连续的计算机断层扫描（CT），通过量化放疗（RT）过程中出现的肿瘤体积缩小，来评估自适应地缩小治疗体积的可能性。
方法和材料：共有22例I - III期非小细胞肺癌患者接受了常规分割放疗；15例同时接受了化疗。在30戈瑞和50戈瑞的标称剂量下进行了两次重复CT扫描。对17例患者使用了呼吸相关的四维CT扫描来评估呼吸影响。在模拟定位以及重复CT扫描的所有各个时相上描绘出大体肿瘤体积（GTV）。除非淋巴结体积更大或是原发灶，否则对肺实质肿瘤进行评估。后续的图像组与模拟数据进行空间配准以用于评估。
结果：在第一次重复扫描时，GTV中位数缩小24.7%（范围，-0.3%至61.7%；双侧t检验，p < 0.001），在第二次重复扫描时为44.3%（范围，0.2 - 81.6%，p < 0.001）。接受放化疗的患者与单纯放疗的患者之间以及GTV >100立方厘米与……之间的体积缩小没有显著差异。
Purpose: Dose escalation for lung cancer is limited by normal tissue toxicity. We evaluated sequential computed tomography (CT) scans to assess the possibility of adaptively reducing treatment volumes by quantifying the tumor volume reduction occurring during a course of radiotherapy (RT).Methods and Materials: A total of 22 patients underwent RT for Stage I-III non-small-cell lung cancer with conventional fractionation; 15 received concurrent chemotherapy. Two repeat CT scans were performed at a nominal dose of 30 Gy and 50 Gy. Respiration-correlated four-dimensional CT scans were used for evaluation of respiratory effects in 17 patients. The gross tumor volume (GTV) was delineated on simulation and all individual phases of the repeat CT scans. Parenchymal tumor was evaluated unless the nodal volume was larger or was the primary. Subsequent image sets were spatially co-registered with the simulation data for evaluation.Results: The median GTV reduction was 24.7% (range, -0.3% to 61.7%; p < 0.001, two-tailed t test) at the first Fe-peat scan and 44.3% (range, 0.2-81.6%, p < 0.001) at the second repeat scan. The volume reduction was not significantly different between patients receiving chemoradiotherapy vs. RT alone, a GTV >100 cm(3) vs.