四维CT前瞻式呼吸门控技术在肺部肿瘤放疗中的应用研究

doi:10.3760/cma.j.cn113030-20211111-00462

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Abstract Objective The respiratory waveform of lung cancer patients based on 4D-CT respiratory gating was analyzed to evaluate the accuracy of gating during radiotherapy, and to explore the off-target in the 4D-CT respiratory gating radiotherapy. Methods Clinical data of 18 patients with lung cancer admitted to Radiotherapy Department of Jiangsu Cancer Hospital were collected to obtain the respiratory waveform data during 4D-CT respiratory gating radiotherapy. The waveform in each treatment working cycle was compared with the waveform in 4D-CT scan to study whether there was a possibility of the off-target in the treatment of lung cancer patients. Results There were 154 treatment sessions and 20,790 treatment breathing cycles in 18 patients, among which the threshold of gated opening beam miss amplitude (Δm-en) was greater than 0 in 95 treatment breathing cycles in 7 patients, accounting for 0.46% of all breathing cycles, and the threshold of gated closing beam miss amplitude (Δm-dis) was greater than 0 in 1419 treatment breathing cycles in 13 patients, accounting for 6.83% of all cycles. Among the 13 patients withΔm-dis greater than 0, actual tumor range of motion (R_G) was greater than the sum of the value of target margin (M) and the value of plan tumor range of motion (R_T) in 7 patients, R_G was more than 1.5 times of M+R_T in 7 patients, and there were also 7 patients in the phase of rapid rise and fall of respiratory curve. The correlation efficients between R_G-M-R_T and the percentage of beam on miss phase (T_en%) and the percentage of beam closing off phase (T_dis%) were 0.41 and 0.57, respectively. Conclusions When R_G is more than 1.5 times of M+R_T value and the gating beam on phase contains the phases in the rapid rise and fall of the respiratory curve, the possibility of the off-target during radiotherapy is significantly increased.

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	Articles by authors
	Yin Li
	Gao Han
	Yuan Fangqin
	Wang Qi
	Liu Yatian
	Zhai Zhenyu
	Jiang Ming
	Sun Li
	Zhang Qian
	Zhu Jun
	He Xia

Key words： Lung neoplasms Respiratory gating Gating accuracy 4D-CT Off-target

Received: 11 November 2021

Fund:; Fund programs: Jiangsu Provincial Science and Technology Department of Clinical Medical Science and Technology Special Fund(BE2019756); Key project of Jiangsu Provincial Health Committee (K2019028); Clinical Fund of Collaborative Innovation Center for Cancer Personalized Medicine of Nanjing Medical University(JZ21449020210616)

Corresponding Authors: He Xia, Email: hexia206@sina.com

Cite this article:

Yin Li,Gao Han,Yuan Fangqin et al. Application of prospective respiratory gating based on 4D-CT in precise radiotherapy for lung cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(7): 605-610.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20211111-00462 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I7/605

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