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目的探讨锥形束计算机断层扫描(CBCT)在非小细胞肺癌放射治疗中的应用价值。方法采用统计学软件对患者CBCT和CT两个计划的大体肿瘤体积(GTV)、计划靶体积(PTV)、双肺V20、Dmean和脊髓最大受量(c Gy)等参数信息进行比较分析。结果 GTVCBCT比GTVCT平均增加约29.9 cm3,但GTVCBCT至PTVCBCT外放边界比GTVCT至PTVCT外放边界平均减少约40.2 cm3。在双肺V20、Dmean和脊髓最大受量方面,CBCT与CT差异均有统计学意义(P<0.05)。结论 CBCT可以减少外放边界,可有效降低肺损伤指标双肺V20、Dmean和脊髓最大受量,从而明显减少正常肺组织与脊髓等放射性损伤的发生率。
Objective To investigate the value of cone beam computed tomography (CBCT) in radiotherapy of non-small cell lung cancer. Methods The statistical software was used to compare the parameters of gross tumor volume (GTV), planned target volume (PTV), lung V20, Dmean and c Gy of CBCT and CT. Results GTVCBCT increased an average of about 29.9 cm3 compared with GTVCT, but the GTVCBCT to PTVCBCT margin decreased by about 40.2 cm3 on average than that of GTVCT to PTVCT. There was significant difference between CBCT and CT in both lung V20, Dmean and spinal cord maximal dose (P <0.05). Conclusion CBCT can reduce the external discharge boundary, which can effectively reduce the lung injury index V20, Dmean and spinal cord maximum dose, thus significantly reducing the incidence of normal lung and spinal cord injury.