同步放化疗中胰腺癌靶区位置及体积变化研究

doi:10.3760/cma.j.issn.1004-4221.2016.12.011

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Abstract

Objective To investigate the variation in target volume and position in radiotherapy for pancreatic cancer based on contrast-enhanced three-dimensional computed tomography (3DCT) images,and to investigate the influence of radiotherapy re-planning during the treatment on doses to organs at risk. Methods Thirty-one patients with pancreatic cancer received contrast-enhanced 3DCT scans before radiotherapy and at the 15^th-18^th fraction. gross tumor volume (GTV) was delineated on the two sets of images. The coordinates and volume of GTV were acquired after automatic registration in the treatment planning system. Radiotherapy plan-1 and plan-2 were made based on the initial target volume (CT-1) and the target volume after 15^th-18^th fraction (CT-2),respectively. Plan-3 was defined by copying plan-1 to the CT-2. The results were analyzed using one-way analysis of variance and Pearson correlation analysis. Results During the treatment,the center of GTV had a significant larger displacement in the superior-inferior direction than in the right-left or anterior-posterior direction ((0.7±0.2) vs. (0.4±0.1) cm,(0.7±0.2) vs. (0.4±0.1) cm,P=0.048);the volume of GTV was significantly reduced by (27.1±17.1)%(P=0.000).The degrees of inclusion (DI) of the two GTVs were 0.6±0.2 and 0.8±0.2(P=0.000).The matching index (MI) was 0.5±0.1.The three-dimensional vector of GTV was negatively correlated with DI and MI (P=0.000,0.000,0.000).Compared with plan-3,the D_mean values for the liver and right kidney in plan-2 were significantly reduced by 21.9% and 14.4%,respectively (P=0.025,0.040). Conclusions The position and volume of GTV have significant changes during conventional fractionation radiotherapy combined with concurrent chemotherapy for pancreatic cancer. Re-planning during the treatment can significantly reduce doses to the liver and right kidney. Therefore,it is necessary to perform target correction and re-planning at an appropriate time during treatment.

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	Sun Jingui
	Li Jianbin
	Wei Hua
	Wang Xiaofang
	Yang Wenchao
	Wang Jinzhi
	Wang Yue
	Liu Tonghai

Key words： Pancreatic cancer/radiotherapy Tomography,X ray computed,three dimentional Concurrent radiochemotherapy Target position Target volume

Received: 08 July 2015

Corresponding Authors: Li Jianbin,Email:lijianbin@msn.com

Cite this article:

Sun Jingui,Li Jianbin,Wei Hua et al. Variation in target volume and position in concurrent chemoradiotherapy for pancreatic cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(12): 1323-1326.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.12.011 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I12/1323

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