The effect of tumor location and respiratory function on tumor movement estimated by real-time tracking radiotherapy (RTRT) system
The effect of tumor location and respiratory function on tumor movement estimated by real-time tracking radiotherapy (RTRT) system
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DOI：
10.1016/j.ijrobp.2005.01.025
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发表时间：
2005-09-01
影响因子：
7
通讯作者：
Miyasaka, K
中科院分区：
文献类型：
--
作者：
Onimaru, R;Shirato, H;Miyasaka, K
目的：评价肿瘤位置和肺功能对肺肿瘤附近基准标志物运动的影响，以推断无基准标志物放射治疗中确定内切的简单指南。方法与材料：对39例患者的42种标志物的实时肿瘤跟踪放疗系统收集的汇总数据进行分析。放疗前评估所有患者的肺功能。使用胸部x线片，标记物的位置相对于单侧肺的几何形状表示。侧位胸片上肺后半部分的位置为后位，侧位胸片上肺后半部分的位置为尾位；这些分类是通过测量标记物与解剖标记物之间的距离来确定的，包括顶点、肋膈角、椎管中线、肺外侧、前、后边界。结果：放疗前，阻塞性呼吸功能障碍18例（1 s用力呼气量与用力肺活量之比[FEV1.0/FVC] < 70），缩窄性呼吸功能障碍5例（肺活量百分比[%VC] < 80），混合性呼吸功能障碍3例。FEV1.0/FVC均值为97.0%，%VC均值为66.5%。肿瘤在x（左右）、y（正位）和z（颅侧）方向的中位移动分别为1.1 mm、2.3 mm和5.4 mm。呼吸功能与标记物向任何方向移动的大小均无显著相关性。颅侧和尾侧标记物在z方向上的中位移动分别为2.6 mm和11.8 mm （p < 0.001）。后位和前位的z向正中移动分别为11.8 mm和3.4 mm （p < 0.01）。结论：胸部x线平片相对位置的简单测量与肺肿瘤附近基准标记物的颅-掌部运动幅度有关，而呼吸功能检查与之无关。(c) 2005爱思唯尔公司
Purpose: The effects of tumor location and pulmonary function on the motion of fiducial markers near lung tumors were evaluated to deduce simple guidelines for determining the internal margin in radiotherapy without fiducial markers.Methods and Materials: Pooled data collected by a real-time tumor-tracking radiotherapy system on 42 markers in 39 patients were analyzed. The pulmonary functions of all patients were assessed before radiotherapy. Using chest X-ray film, the position of the marker was expressed relative to the geometry of the unilateral lung. Posterior location meant the area of the posterior half of the lung in a lateral chest X-ray film, and caudal location meant the caudal half of the chest X-ray film; these categories were determined by measuring the distance between the marker and anatomic landmarks, including the apex, costophrenic angle, midline of spinal canal, lateral, anterior, and posterior boundary of the lung.Results: Before the radiotherapy, 18 patients had obstructive respiratory dysfunction (ratio of forced expiratory volume in 1 s to forced vital capacity [FEV1.0/FVC] < 70), 5 patients had constrictive dysfunction (percent vital capacity [%VC] < 80), and 3 had mixed dysfunction. Means of FEV1.0/FVC and %VC were 97.0% and 66.5%, respectively. Median tumor movements in the x (left-right), y (anteroposterior), and z (craniocaudal) directions were 1.1 mm, 2.3 mm, and 5.4 mm, respectively. There was no significant correlation between respiratory function and magnitude of marker movement in any direction. Median marker movement in the z direction was 2.6 mm for the cranial location and 11.8 mm for the caudal location, respectively (p < 0.001). Median movement in the z direction was 11.8 mm for posterior location and 3.4 mm for anterior location, respectively (p < 0.01).Conclusions: Simple measurement of the relative location on plain chest X-ray film was related, but respiratory function test was not related, to the craniocaudal amplitude of the motion of the fiducial marker near lung tumors. (c) 2005 Elsevier Inc.