[1]张伟,郇福奎,张彦新,等.螺旋断层调强放疗进行全中枢神经系统照射时不同部位靶区外放的临床研究[J].中国医学物理学杂志,2022,39(11):1334-1338.[doi:DOI:10.3969/j.issn.1005-202X.2022.11.003]
　ZHANG Wei,HUAN Fukui,ZHANG Yanxin,et al.Margin expansions of different regions of interest in craniospinal irradiation using helical tomotherapy[J].Chinese Journal of Medical Physics,2022,39(11):1334-1338.[doi:DOI:10.3969/j.issn.1005-202X.2022.11.003]
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螺旋断层调强放疗进行全中枢神经系统照射时不同部位靶区外放的临床研究()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第11期
页码:
1334-1338
栏目:
医学放射物理
出版日期:
2022-11-25

文章信息/Info

Title:
Margin expansions of different regions of interest in craniospinal irradiation using helical tomotherapy
文章编号:
1005-202X（2022）11-1334-05
作者:
张伟; 郇福奎; 张彦新; 李谭谭; 李伟; 黄鹏; 胡志辉; 覃仕瑞; 门阔; 罗京伟
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科， 北京 100021
Author(s):
ZHANG Wei;  HUAN Fukui;  ZHANG Yanxin;  LI Tantan;  LI Wei;  HUANG Peng;  HU Zhihui;  QIN Shirui;  MEN Kuo;  LUO Jingwei
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
关键词:
全中枢神经系统放疗; 螺旋断层调强放疗; 摆位误差; 靶区外放
Keywords:
Keywords: craniospinal irradiation helical tomotherapy setup error target volume margin expansion
分类号:
R811
DOI:
DOI:10.3969/j.issn.1005-202X.2022.11.003
文献标志码:
A
摘要:
目的：分析使用螺旋断层加速器TOMO进行全中枢神经系统放疗的患者的MVCT图像，以颅骨、颈椎、胸椎、腰椎和整体靶区（PTVROI）为感兴趣区分别进行图像配准和摆位误差统计，计算各感兴趣区的靶区外放。方法：回顾性分析中国医学科学院肿瘤医院2016年~2020年使用TOMO行全中枢神经系统放疗的16例患者的154套MVCT图像，分别以颅骨、颈椎、胸椎、腰椎和PTVROI进行配准，统计不同部位靶区的摆位误差数据，得到5组包含左右（X）方向、头脚（Y）方向、腹背（Z）方向的摆位误差数据，比较颅骨、颈椎、胸椎、腰椎和PTVROI是否有差异，并应用公式M=2.5Σ+0.7σ分别计算不同部位的临床靶区到计划靶区的外放边界。结果：在X方向上的两两比较中，颅骨vs颈椎，差异有统计学意义（P=0.023），其余各组比较均无显著性差异；Y方向上的两两比较均未显示有显著性差异；而在Z方向上，PTVROI vs颅骨、PTVROI vs胸椎，无显著性差异，其他组两两比较，PTVROI vs颈椎（P<0.001）、PTVROI vs腰椎（P<0.001）、颅骨vs颈椎（P=0.007）、颅骨vs胸椎（P=0.017）、颅骨vs腰椎（P<0.001）、颈椎vs胸椎（P<0.001）、颈椎vs腰椎（P<0.001）、胸椎vs腰椎（P<0.001），差异有统计学意义。结论：使用TOMO行全中枢神经系统放疗，Y方向的靶区外放差异较小，X和Z方向的靶区外放边界从头到腰椎呈递增趋势，建议在中枢的不同位置采取不同的PTV外放策略。
Abstract:
Abstract: Objective To carry out image registration and setup error analysis with skull, cervical spine, thoracic vertebra, lumbar vertebra and the whole planning target volume (PTV) in MVCT images of patients treated by craniospinal radiotherapy using helical tomotherapy (TOMO) as regions of interest (SROI, CROI, TROI, LROI, PTVROI, respectively), and to calculate the margin expansion of each ROI. Methods A total of 154 sets of MVCT images of 16 patients who received craniospinal radiotherapy using TOMO in Cancer Hospital, Chinese Academy of Medical Sciences from 2016 to 2020 were analyzed retrospectively. The skull, cervical spine, thoracic spine, lumbar spine and planning target volume were registered separately. The setup errors of different regions were recorded, and 5 groups of setup errors including X (left-right), Y (superior-inferior) and Z (anterior-posterior) directional setup errors were obtained to analyze the difference among SROI, CROI, TROI, LROI and PTVROI, and the formula M=2.5Σ+0.7σ was applied to calculate the CTV-PTV margin of each ROI. Results The differences in X directional setup errors between any two groups were trivial, except for SROI vs CROI (P=0.023) and the Y directional setup erros in any two groups were close. The compassion of Z directional setup error showed that there were statistically significant differences in PTVROI vs CROI (P<0.001), PTVROI vs LROI (P<0.001), SROI vs CROI (P=0.007), SROI vs TROI (P=0.017), SROI vs LROI (P<0.001), CROI vs TROI (P<0.001), CROI vs LROI (P<0.001), TROI vs LROI (P<0.001), but not in PTVROI vs SROI, PTVROI vs TROI. Conclusion In craniospinal irradiation using TOMO, the difference in Y directional PTV margin expansion is insignificant, but the X and Z directional margin expansions show an increasing trend from head to lumbar spine. It is suggested that different PTV margin expansion strategies should be adopted at different craniospinal regions.

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备注/Memo

备注/Memo:
【收稿日期】2022-05-16 【基金项目】国家自然科学基金（11975313） 【作者简介】张伟，主要从事图像引导放射治疗研究，E-mail: zhangwei0312@163.com 【通信作者】覃仕瑞，E-mail: shiruiok@126.com
更新日期/Last Update: 2022-11-25