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[目的]探索食管癌适形放疗中呼吸运动对靶区的影响,为靶区的勾画提供依据。[方法]对23例确诊食管癌患者分别于平静呼吸、平静吸气末、平静呼气末状态下对靶区行CT扫描,将扫描图像传输至治疗计划系统,进行图像融合,并测量靶区动度数据。[结果]肿瘤靶区几何中心在Y轴、X轴、Z轴方向上呼吸动度的平均值,10例中段食管癌患者分别为0.46±0.14cm,0.52±0.26cm,0.59±0.26cm;13例下段食管癌患者分别为1.17±0.69cm,0.95±0.74cm,0.82±0.35cm。取95%可信区间作为GTV外扩边界,23例食管癌靶区在三维方向上位移分别为上侧0.74cm,下侧1.62cm,左侧0.91cm,右侧0.66cm,前侧0.87cm,后侧0.59cm。[结论]受呼吸运动影响食管癌GTV几何中心在Y轴、X轴、Z轴方向均会发生不同程度的移位,勾画靶区时中应充分考虑这一因素。
[Objective] To explore the influence of respiratory exercise on the target area in conformal radiotherapy of esophageal cancer and provide the basis for the outline of the target area. [Methods] Twenty-three patients with esophageal cancer underwent CT scanning under the state of calm breathing, calm inhalation and calm end-expiration respectively. The scanned images were transmitted to the treatment planning system for image fusion and the target area Dynamic data. [Results] The mean values of respiratory motility of geometric center of tumor target in Y axis, X axis and Z axis were 0.46 ± 0.14cm, 0.52 ± 0.26cm and 0.59 ± 0.26cm, respectively Cases of lower esophageal cancer patients were 1.17 ± 0.69cm, 0.95 ± 0.74cm, 0.82 ± 0.35cm. Take 95% confidence interval as GTV outward expansion boundary, 23 cases of esophageal cancer target displacement in the three-dimensional directions were the upper 0.74cm, the lower 1.62cm, the left 0.91cm, the right 0.66cm, the anterior 0.87cm, Rear 0.59cm. [Conclusion] The geometric center of GTV affected by respiratory movement may shift in different degrees in the directions of Y axis, X axis and Z axis. This factor should be fully taken into account when designing the target area.