The variability of the clinical target volume for rectal cancer due to internal organ motion during adjuvant treatment
The variability of the clinical target volume for rectal cancer due to internal organ motion during adjuvant treatment
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DOI：
10.1016/s0360-3016(02)02753-0
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发表时间：
2002-06-01
影响因子：
7
通讯作者：
Martinez, A
中科院分区：
文献类型：
--
作者：
Nuyttens, JJ;Robertson, JM;Martinez, A
目的：本研究定义了直肠癌辅助治疗的临床靶体积（CTV），并将该定义应用于在典型的5周治疗过程中获得的多次CT扫描，以测量由于内部器官运动而对CTV的修改，这是定义计划靶体积（PTV）所需的。10例直肠癌患者在辅助放疗期间接受了每周治疗计划CT扫描。所有患者均给予口服造影剂，俯卧在具有凹陷区域的硬质泡沫支架上进行小肠阻断，并指示膀胱充盈。根据骨盆骨骼配准CT扫描，并在每个CT切片上勾画CTV。测量CTV在所有维度上的运动。结果：CTV的最大差值出现在距肛门尾部10 cm处，标准差为1 cm。膀胱充盈使CTV的前缘在2.5cm的颅-尾长度上平均移位7 mm。CTV的其他边界是基于肌肉，骨骼，或主要血管，是stabil.Conclusion：修改CTV设计PTV可以是不平等的，最大的变化在前边缘的骨盆下部。(C)2002年爱思唯尔科技有限公司
Purpose: This study defined the clinical target volume (CTV) for the adjuvant treatment of rectal cancer and applied this definition to multiple CT scans obtained during the typical 5-week course of treatment to measure the modification to the CTV due to internal organ motion that would be needed to define the planning target volume (PTV).Methods and Materials: Ten patients with rectal cancer had weekly treatment planning CT scans during adjuvant radiation therapy. All patients were given oral contrast, placed prone on a rigid foam cradle with a depressed area for small bowel exclusion, and instructed to have a full bladder. The CT scans were registered according to the bones of the pelvis, and the CTV was outlined on each CT slice. Movement of the CTV in all dimensions was measured. The CT scan with the lowest and highest bladder volume for each patient was used to calculate the CTV movement due to bladder filling.Results: The largest difference in the CTV occurred 10 cm caudal to the anus, with a standard deviation of I cm. bladder filling displaced the anterior border of the CTV an average of 7 mm over a cranial to caudal length of 2.5 cm. Other borders of the CTV were based on muscle, bone, or major blood vessels and were stable.Conclusion: Modification of the CTV to design a PTV can be unequal, with the largest change at the anterior border of the inferior pelvis. (C) 2002 Elsevier Science Inc.