Abstract:Objective To study the effectiveness of application of CTVision system in analysis of the change law of the target volume and dose for nasopharyngeal carcinoma in the course of radiotherapy. Methods Image-guided IMRT (Intensity-Modulated Radiation Therapy) was performed in 10 patients with nasopharyngeal carcinoma by using CTVision system to analyze the change law of the volume of target area and parotids. Then, the CT images were transmitted back to the TPS (Treatment Planning System) for recalculation and analysis of the dose for organs at risk. Results The volume of target area as well as the volume of bilateral parotids was diminishing with the progress of radiotherapy. And the volume of target area as well as the volume of right-sided parotids revealed obvious differences in the 4th week of radiotherapy from the pre-treatment volume. The volume of left-sided parotids revealed obvious differences in the 5th week of radiotherapy from the pre-treatment volume. Meanwhile, the radiation dose received by bilateral parotids increased gradually with the shrinkage of the volume, and was positively associated with the shrinkage degree (Right-sided parotids: r=0.471, P=0.036; Left-sided parotids: r=0.578, P=0.008). Conclusion For nasopharyngeal carcinoma patients who were experiencing IMRT, the volume of target area and parotids was shrinking with the progress of radiotherapy, leading to the increasing of the dose for organs. In view of this, it was suggested to redraw the outline of the target area and redesign the radiotherapy plan in the 4th to 5th week in of IMRT, which would improve the local control rate of nasopharyngeal carcinoma and reduce the side effects of radiation.
甘晓根,徐子海,廖福锡. CTVision系统在分析鼻咽癌放疗过程靶区体积及其剂量学变化规律中的应用[J]. 中国医疗设备, 2015, 30(11): 35-38.
GAN Xiao-gen, XU Zi-hai, LIAO Fu-xi. Application of CTVision System in Analysis of the Change Law of the Target Volume and Dose for Nasopharyngeal Carcinoma in the Course of Radiotherapy. China Medical Devices, 2015, 30(11): 35-38.
Dubbena HH,Thames HD,Beck-bornholdt HP.Tumor volume:a basic and specific response predictor in radiotherapy[J].Radiotherapy and Oncology,2010,(47):1726-1741.
[12]
Wang X,Lu J,Xiong X,et al.Anatomic and dosimetric changes during the treatment course of intensity modulated radiotherapy for locally advanced nasopharyngeal carcinoma[J].Med Dosim,2010,35(2):151-157. cabde图1 靶区体积缩小示例图注:a.
[2]
Kam MK,Teo PM,Chau RM,et al.Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:The Hong Kong experience[J].Int J Radiat Oncol Biol Phys,2011,60(2):1440-1450.
[12]
Wang X,Lu J,Xiong X,et al.Anatomic and dosimetric changes during the treatment course of intensity modulated radiotherapy for locally advanced nasopharyngeal carcinoma[J].Med Dosim,2010,35(2):151-157. cabde图1 靶区体积缩小示例图注:a.
[2]
Kam MK,Teo PM,Chau RM,et al.Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:The Hong Kong experience[J].Int J Radiat Oncol Biol Phys,2011,60(2):1440-1450.
Dubbena HH,Thames HD,Beck-bornholdt HP.Tumor volume:a basic and specific response predictor in radiotherapy[J].Radiotherapy and Oncology,2010,(47):1726-1741.
[2]
Kam MK,Teo PM,Chau RM,et al.Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:The Hong Kong experience[J].Int J Radiat Oncol Biol Phys,2011,60(2):1440-1450.
[3]
Lee N,Xia P,Quivey JM,et al.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:An update of the UCSF experience[J].Int J Radiat Oncol Biol Phys,2002,53(4):12-22.
[3]
Lee N,Xia P,Quivey JM,et al.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:An update of the UCSF experience[J].Int J Radiat Oncol Biol Phys,2002,53(4):12-22.
[3]
Lee N,Xia P,Quivey JM,et al.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:An update of the UCSF experience[J].Int J Radiat Oncol Biol Phys,2002,53(4):12-22.
John J,Kim Ian F,Tannock.Repopulation of cancer cells during therapy:an important cause of treatment failure[J].Nature,2011,7(5):516-526.
[6]
John J,Kim Ian F,Tannock.Repopulation of cancer cells during therapy:an important cause of treatment failure[J].Nature,2011,7(5):516-526.
[6]
John J,Kim Ian F,Tannock.Repopulation of cancer cells during therapy:an important cause of treatment failure[J].Nature,2011,7(5):516-526.
[7]
Dubbena HH,Thames HD,Beck-bornholdt HP.Tumor volume:a basic and specific response predictor in radiotherapy[J].Radiotherapy and Oncology,2010,(47):1726-1741.
[8]
Robar JL,Day A,Clancey J,et al.Spatial and dosimetric variability of organs at risk in head-and-neck intensity-modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2007,68(4):1121-1130.
[9]
Han C,Chen YJ,Liu A,et al.Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy[J].Int J Radiat Oncol Biol Phys,2008,70(4):1256-1262.
[9]
Han C,Chen YJ,Liu A,et al.Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy[J].Int J Radiat Oncol Biol Phys,2008,70(4):1256-1262.
[8]
Robar JL,Day A,Clancey J,et al.Spatial and dosimetric variability of organs at risk in head-and-neck intensity-modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2007,68(4):1121-1130.
[8]
Robar JL,Day A,Clancey J,et al.Spatial and dosimetric variability of organs at risk in head-and-neck intensity-modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2007,68(4):1121-1130.
[9]
Han C,Chen YJ,Liu A,et al.Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy[J].Int J Radiat Oncol Biol Phys,2008,70(4):1256-1262.
[10]
Lee C,Langen KM,Lu W,et al.Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration[J].Int J Radiat Oncol Biol Phys,2008,71(5):1563-1571.
[10]
Lee C,Langen KM,Lu W,et al.Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration[J].Int J Radiat Oncol Biol Phys,2008,71(5):1563-1571.
[10]
Lee C,Langen KM,Lu W,et al.Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration[J].Int J Radiat Oncol Biol Phys,2008,71(5):1563-1571.
[11]
Broggi S,Fiorino C,Dell Oca I,et al.A two-variable linear model of parotid shrinkage during IMRT for head and neck cancer[J].Radiother Oncol,2012,94(2):206-212.
[11]
Broggi S,Fiorino C,Dell Oca I,et al.A two-variable linear model of parotid shrinkage during IMRT for head and neck cancer[J].Radiother Oncol,2012,94(2):206-212.
[11]
Broggi S,Fiorino C,Dell Oca I,et al.A two-variable linear model of parotid shrinkage during IMRT for head and neck cancer[J].Radiother Oncol,2012,94(2):206-212.
[12]
Wang X,Lu J,Xiong X,et al.Anatomic and dosimetric changes during the treatment course of intensity modulated radiotherapy for locally advanced nasopharyngeal carcinoma[J].Med Dosim,2010,35(2):151-157. cabde图1 靶区体积缩小示例图注:a.