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[目的]观察非小细胞肺癌(NSCLC)三维适形放疗(3D-CRT)中增强CT定位对放疗计划参数的影响。[方法]对97例在CT定位下拟行根治性3D-CRT的NSCLC患者,分别以CT平扫图像、增强CT图像勾画大体肿瘤靶区(GTVCT和GTVCT+),分别制定放疗计划。[结果]增强CT明显改变35例(36.1%)患者PTV和/或GTV。增强CT组与平扫CT组的计划参数GTV的体积(VGTV)、受照射量≥45Gy的食管占全食管体积的比例(VE45)和脊髓最大受照射剂量(SCM)差异有统计学意义(P均<0.001)。[结论]利用增强CT定位能更加准确地确定靶区,据此制定3D-CRT可更优的覆盖靶区,降低脊髓、食管的受照射剂量。
[Objective] To investigate the effect of enhanced CT localization on radiotherapy planning parameters in three-dimensional conformal radiotherapy (3D-CRT) of non-small cell lung cancer (NSCLC). [Methods] Ninety-seven patients with non-small cell lung cancer (NSCLC) undergoing CT-targeted radical nephrectomy were enrolled in this study. The general tumor targets (GTVCT and GTVCT +) were sketched with CT images and enhanced CT images respectively. [Results] Enhanced CT markedly changed PTV and / or GTV in 35 patients (36.1%). The volume of GTV (VGTV), esophageal total esophageal volume (VE45) and maximum spinal cord irradiation dose (SCM) in CT group and CT group were significantly different (P All <0.001). [Conclusion] The target area can be more accurately determined by enhanced CT localization. 3D-CRT can be used to better cover the target area and reduce the exposure dose of spinal cord and esophagus.