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目的探讨主动呼吸门控系统对非小细胞肺癌患者三维适型放射治疗中放射性肺损伤指标的变化研究。方法将15例确诊非小细胞肺癌患者分别在主动呼吸门控系统(ABC)和自由呼吸条件(FB)下CT扫描相同体位,制定两套三维适型放射治疗计划,由计算机系统列出两套计划的DVH。根据DVH计算得到两个三维适型放射治疗计划的数据指标:患侧肺大于20Gy肺的体积与总体积的比例(V20)、患侧肺的体积、患侧肺平均受照剂量。结果FB条件下放疗计划与ABC条件下放疗计划患侧肺的V20分别为(26.13±3.88)%、(17.82±3.94)%,应用ABC系统条件下放射治疗相比FB条件下放射治疗V20减小(P<0.01);FB条件下放疗计划与ABC条件下放疗计划患侧肺的体积分别为(1.05±0.28)×103cm3、(1.46±0.28)×103cm3,应用ABC系统条件下放射治疗相比FB条件下放射治疗患侧肺的体积增大(P<0.01);FB条件下放疗计划与ABC条件下放疗计划患侧肺平均受照剂量分别为(1.70±0.21)×103cGy、(1.43±0.27)×103cGy,应用ABC系统条件下放射治疗相比FB条件下放射治疗患侧肺的平均受照剂量减少(P<0.01)。结论主动呼吸门控系统在非小细胞肺癌精确放疗中具有提高肿瘤局部控制率和降低肺组织受照剂量的作用。
Objective To investigate the changes of radioactive lung injury in patients with non-small cell lung cancer undergoing three-dimensional adaptive radiation therapy under active respiratory gating system. Methods Fifteen patients with confirmed non-small cell lung cancer underwent CT scan of the same position under active respiration gating system (ABC) and free respiration condition (FB) respectively. Two sets of three-dimensional conformal radiation therapy plans were made. Two sets of computer- Scheduled DVH. According to DVH, the data indexes of two three-dimensional conformal radiotherapy plans are obtained: the ratio of the volume of the affected lung to the total volume of 20Gy lungs (V20), the volume of the affected lungs and the average dose of the affected lungs. Results V20 was (26.13 ± 3.88)% and (17.82 ± 3.94)%, respectively, in the lung of FB patients under FB condition compared with that under ABC condition. Compared with FB condition, V20 of ABC patients treated with radiotherapy was decreased (1.05 ± 0.28) × 103cm3, (1.46 ± 0.28) × 103cm3, respectively. Compared with the FB treatment, the volume of lungs in the radiotherapy plan under ABC condition (1.70 ± 0.21) × 103cGy, (1.43 ± 0.27) days after radiotherapy under FB condition and ABC condition, respectively × 103cGy. Compared with the FB system, the mean radiation dose of radiation therapy in the lungs of patients receiving ABC system decreased (P <0.01). Conclusions The active respiratory gating system can improve the local control rate of tumor and reduce the dose of lung tissue in the precise radiotherapy of non-small cell lung cancer.