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目的研究非小细胞肺癌三维适形放疗(3D-CRT)过程中,再次CT定位和计划实施对肿瘤剂量、正常肺组织和正常组织并发症概率的影响。方法将首次定位CT图像CT1作为A计划的图像,并设计和优化该计划。B为接受40Gy后的A计划和由CT2图像和CT1图像按照解剖结构和骨性标志融合后形成的新治疗计划b的总计划。在相同的处方剂量60Gy的条件下,比较A计划和B计划肺的V5、V20、肺平均剂量(mean lung dose,MLD)和正常组织并发症概率(normal tissue complication probabilities,NTCP)。结果 A和B比较V5差异无统计学意义(P>0.05),V20、MLD和NTCP差异均有统计学意义(P<0.05)。结论肺癌三维适形放疗(3D-CRT)过程中,再次CT定位和计划实施能使患者获益,减少正常组织发生并发症概率。
Objective To study the effect of CT location and planning on the dose of tumor, the probability of normal lung tissue and normal tissue in the course of 3D-CRT of non-small cell lung cancer. The method first positions the CT image CT1 as the image of the A plan, and designs and optimizes the plan. B is the master plan for a plan A after receiving 40 Gy and a new plan of treatment b resulting from the fusion of CT2 images and CT1 images in accordance with the anatomical and osseous signs. The V5, V20, mean lung dose (MLD) and normal tissue complication probabilities (NTCP) of the A and B plans were compared under the same prescription dose of 60 Gy. Results There was no significant difference in V5 between A and B (P> 0.05). There was significant difference between V20, MLD and NTCP (P <0.05). Conclusions During 3D-CRT of lung cancer, CT positioning and planning again can benefit patients and reduce the probability of complications in normal tissues.