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目的对肺癌患者三维适形调强放疗中呼吸运动对肺移动度的影响进行观察研究,明确肿瘤靶区的勾画标准。方法对137名已确诊肺部病灶的肺癌患者行CT定位扫描和靶区勾画。对肿瘤在X、Y两个方向的运动幅度数据进行收集和统计,对男女差异进行比较。结果位于肺下叶部位的肿瘤因呼吸运动而引起的X,Y方向上位移均较上中叶肿瘤明显,差异均有统计学意义(P<0.05)。男性上中叶部位肿瘤在X轴和Y轴方向的平均位移分别为(2.09±0.31)mm和(3.82±1.18)mm,与女性上中叶肿瘤在相应方向上的位移(3.06±0.82)mm和(5.59±1.08)mm相比,差异均有统计学意义(P<0.05)。在下叶部位肿瘤的位移差异上,X轴方向上男性与女性差异不大(P>0.05),而Y轴方向男性明显小于女性,分别为(9.39±2.48)mm和(11.82±3.47)mm,差异有统计学意义(P<0.05)。结论呼吸运动所引起的肿瘤位移男性普遍较女性小,且下叶位移较上中叶位移幅度明显。
Objective To observe the effect of respiration on lung mobility in patients with lung cancer under three-dimensional conformal intensity-modulated radiation therapy, and to define the delineation standard of tumor target area. Methods Totally 137 lung cancer patients with confirmed lung lesions underwent CT mapping and target mapping. The data of movement amplitude of the tumor in X and Y directions were collected and compared, and the differences between men and women were compared. Results The displacement of the tumor located in the lower lobe of lung due to respiratory movement was significantly higher than that of the middle and upper lobe tumor in both X and Y directions. The difference was statistically significant (P <0.05). The average displacement of the middle and upper middle part of the male in the X axis and the Y axis were (2.09 ± 0.31) mm and (3.82 ± 1.18) mm, respectively, and the displacement in the corresponding direction was (3.06 ± 0.82) mm and ( 5.59 ± 1.08) mm, the difference was statistically significant (P <0.05). There were no significant differences in the displacement of the tumor in the lower lobe between men and women in the X-axis (P> 0.05), while those in the Y-axis were significantly less than those in the women (9.39 ± 2.48 mm and (11.82 ± 3.47) mm, The difference was statistically significant (P <0.05). Conclusion Respiratory motility caused by the movement of men than women are generally smaller, and the displacement of lower lobe than the displacement of the middle of the obvious.