非小细胞肺癌术后放射治疗纵隔移位研究

doi:10.3760/cma.j.cn113030-20211026-00432

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Abstract Objective To analyze the mediastinal displacement of target volume in the postoperative radiotherapy (PORT) process for non-small cell lung cancer (NSCLC) and the value of mid-term evaluation. Methods For 100 patients with postoperativeN2stage NSCLC, R1-2 and any N staging, bone anatomy was utilized to measure the change of the first and second CT localization on the same level. Statistical analysis were performed using the WilCoxon, Kruskal-Wallis and χ² tests. The cut-off values were calculated with the receiver operating characteristic (ROC) curve. Results Among the included patients, in the PORT process, the mediastinal displacement in the x (front and rear), Y (left and right) and Z (upper and lower) directions were 0.04-0.53cm, 0.00-0.84cm and 0.00-1.27cm, respectively, and the order of mediastinal displacement distance wasz >Y>X, respectively. According to the ROC curve calculation, the cut-off values were 0.263, 0.352 and 0.405, respectively, which were greater than the cut-off values in 25 cases (25%), 30 cases (30%) and 30 cases (30%), respectively. There was significant difference in the three-dimensionalmediastinal displacement (P=0.007,<0.001 and<0.001). The mediastinal displacement in thex, Y and Z directions had no statistical significance regarding resection site (P=0.355, 0.239 and 0.256) and operation mode (P=0.241, 0.110 and 0.064). Comparative analysis of modified whole group mediastinal shift> and cut-off values, medium-simulation (m-S) and the originally planned radiotherapy shown that there was no significant difference in the incidence of radiation esophagitis (RE) and radiation pneumonitis in PORT patients (all P>0.05);however, the incidence of ≥grade 3 RE in the modified plan after m-S was significantly lower than that in the originally planned PORT patients, which were 0 and 7%, respectively (P<0.001). Conclusions Mediastinal displacement exists in the PORT process of N2 or/and R1-2 cases after radical operation of NSCLC, and obvious movement occurs in 20%-30% of patients. Relocating and modifying the target volume and radiotherapy plan in the middle of the PORT process is beneficial to quality assurance and quality control.

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	Articles by authors
	Zhang Wei
	Zhang Yi
	Hong Wei
	Ouyang Weiwei
	Su Shengfa
	Ma Zhu
	Li Qingsong
	Yang Wengang
	Chen Xiaxia
	Liu Jie
	Lu Bing

Key words： Mediastinal displacement Carcinoma, non-small cell lung/postoperative radiotherapy Quality assurance Quality control

Received: 26 October 2021

Fund:Science Fund of Guizhou Provincial Health and Family Planning Commission in 2018(gzwjkj2018-1-006)

Corresponding Authors: Lu Bing, Email:lbgymaaaa@163.com

Cite this article:

Zhang Wei,Zhang Yi,Hong Wei et al. Study on quality control of mediastinal shift radiotherapy with target volume after operation for non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(3): 242-247.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20211026-00432 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I3/242

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