论文部分内容阅读
目的:探讨迷走右锁骨下动脉(ARSA)对食管癌和肺癌精确放射治疗靶区与危及器官(OAR)的体积及受照剂量的影响。方法:食管癌或肺癌合并ARSA患者,在相同的射野参数条件下,分别计算ARSA误诊(F组)和正确诊断(R组)时精确放射治疗靶区和OAR的体积及受照剂量。结果:在处方剂量和90%靶区体积的百分处方剂量相近的情况下,ARSA误诊合并食管癌、右肺癌行精确放疗时,可不同程度增加GTV、CTV、PTV体积和受照剂量,及心脏、肺、脊髓受照剂量和脊髓受照长度。在F组中,合并食管癌胸上段的GTV、CTV和PTV体积增加最大,占40%～50%;合并食管癌胸下段的GTV、CTV和PTV平均剂量增加最大,约40%;合并食管癌时,心脏、肺、脊髓的平均剂量增加最大,占30%～85%;合并肺癌时,靶区、心脏、肺、脊髓的各项评价指标变化最小,≤12%。结论:ARSA误诊可以不同程度的增加食管癌和肺癌精确放疗的靶区和OAR的体积及受照剂量。
Objective: To investigate the effect of vagal right subclavian artery (ARSA) on volume and dose of targeted radiotherapy and risk organ (OAR) in esophageal and lung cancer. Methods: The volume of esophageal cancer or lung cancer patients with ARSA and the volume of targeted radiotherapy and OAR when the ARSA was misdiagnosed (group F) and correctly diagnosed (group R) were calculated under the same field parameters. Results: ARSA misdiagnosed with esophageal cancer and right lung cancer underwent accurate radiotherapy with varying doses of GTV, CTV, PTV and doses at similar percentages of prescription dose and 90% Heart, lung, spinal cord exposure dose and spinal cord length of exposure. In group F, the volume of GTV, CTV and PTV in the upper thoracic esophageal carcinoma was the largest, accounting for 40% -50%. The average dose of GTV, CTV and PTV in the thoracic segment of esophageal cancer increased most, about 40% , The average dose of heart, lung and spinal cord increased the most, accounting for 30% -85%. When combined with lung cancer, the indexes of target area, heart, lung and spinal cord had the least change, ≤12%. Conclusions: Misdiagnosis of ARSA can increase the volume and dose of targeted radiotherapy and OAR in patients with esophageal cancer and lung cancer.