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食管癌放疗脊髓外扩范围应用研究
魏胜涛1,2, 刘杨1, 王祥1, 张海三2, 李定杰1
1郑州大学附属肿瘤医院放疗科,郑州 450008; 2新乡市多模态脑影像重点实验室 453002
Application of radiotherapy with the extension of spinal cord for esophageal cancer
Wei Shengtao1,2, Liu Yang1, Wang xiang1, Zhang Haisan2, Li Dingjie1
1Department of Radiotherapy, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China; 2Xinxiang City Key Laboratory of Multimodal Brain Imaging, Xinxiang 453002, China
Abstract：Objective To analyze the setup and residual errors of spinal cord during online CT-guided radiotherapy for patients with esophageal cancer, and to discuss the necessity of segmental extension of spinal cord. Methods According to the radiotherapy site, 60 cases of esophageal cancer were divided into the neck, chest and abdomen groups, 20 cases in each group. Cervical pleura or vacuum bag was fixed, IMRT technology was adopted, and pre-treatment CT images were obtained by CTVision, and 20 consecutive CT scans were collected for each case. CT images were imported into MIM software. The parameters of the setup errors were processed and extracted. The CT spinal cord was delineated for verification and planning, and the Dice coefficient, Hausdorff maximum distance and centroid coordinate of the delineated spinal cord were processed and extracted. Compatibility anova data were adopted. The calculation formula of the extension margin is MPRV= 1.3 ∑total+0.5 σtotal. Results Residual centroid method was employed. Non-on-line and on-line CT-guided radiotherapy, the extension margins of neck,chest, abdominal spinal cord in the x-, y-and z-axis were 3.86,5.37,6.36 mm;3.45,3.83,4.51 mm;4.05,4.83,7.06 mm,vs,2.85,2.19,2.83 mm;2.32,2.20,2.16 mm;2.86,2.21,2.83 mm, respectively. During residual Hausdorff distance method,non-on-line and on-line CT guided radiotherapy,the extension margins of neck, chest, abdominal spinal cord in the x-, y-and z-axis were 3.10, 5.33,6.15 mm;3.30,3.77,4.61 mm;3.35,4.76,6.87mm,vs,2.12,2.06,2.32 mm;2.12,2.06,2.32 mm;2.12,2.06,2.32 mm,respectively. Conclusion The setup errors and residual errors are different in each segment of spinal cord. Henc, different extension margins should be given.
Wei Shengtao,Liu Yang,Wang xiang et al. Application of radiotherapy with the extension of spinal cord for esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(12): 1025-1029.
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