鼻咽癌再程放疗计划时腮腺体积和CT值的变化
The Changes of the Volume and the CT Number of Parotid Gland to Replan during Radiotherapy for Nasopharyngeal Cancer
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摘要: 目的 研究鼻咽癌放射治疗20次后进行再程计划时腮腺体积及CT值的变化.方法 选择昆明医科大学第一附属医院肿瘤放疗2016年11月至2017年6月期间治疗的14例鼻咽癌放射患者, 每例患者均在治疗20次后再次进行定位CT扫描作再程计划.对比治疗前CT和再程计划CT中腮腺体积及腮腺CT值的变化.以脑干的体积和CT值变化作为参照, 采用SPSS对结果作配对t检验统计分析, 有统计学意义 (P<0.05) .结果 14例患者右侧腮腺治疗前和再程计划 (治疗20次后) 、CT值标准差的平均值为26.5和35.6 (P=0.04) 、体积的平均值分别为24.6 cm3和16.1 cm3 (P=0.002) .左侧腮腺治疗前和再程计划CT值平均值分别为4.4和-1.8 (P=0.024) 、CT值标准差的平均值为29.7和35.5 (P=0.026) 、体积的平均值分别为24.1 cm3和16.7 cm3 (P=0.001) .脑干治疗前和再程计划CT33.6和32.3 (P=0.09) 、CT值标准差的平均值为11.9和11.3 (P=0.58) 、脑干体积的平均值分别为28.7 cm3和28.9 cm3 (P=0.887) .结论 左右腮腺体积照射20次后均明显缩小, 腮腺CT值的平均值明显降低, 标准差明显增大;脑干体积、CT值的平均值及标准差均无明显变化.CT值变化可作为目前鼻咽癌临床放疗再程计划和未来自适应计划的一个新的参考数据.Abstract: Objective This study is aimed to compare the CT number and volume of the parotid of the NPC patients between the first CT scan and the rescanning after 20 fractions.Method 14 NPC patients who had been treated were selected for analysis. Each patient was rescanned after the treatment of 20 fractions as the same protocol of the first CT sim for replanning. The CT number and volume change of the Parotid were compared and the CT number and volume change of the brain stem were also evaluated as a reference data. The results were analyzed with SPPS19, The results were analyzed with SPPS19 for t test. Results Mean right parotid CT number of the 14 patients for pre treatment and re-plan (after 20 fractions) was 6.4 and-0.5 ( P = 0.02) separately, the mean stand deviation was 26.5 and 35.6 (P = 0.04) separately、 the mean volume was 24.6 cm3 and 16.1 cm3 ( P = 0.002) separately. Mean left parotid CT number of the 14 patients for pre treatment and re-plan was 4.4 and-1.8 ( P = 0.024) separately, the mean stand deviation is 29.7 and 35.5 ( P = 0.026) separately、 the mean volume was 24.1 cm3 and 16.7 cm3 ( P = 0.001) separately. The Mean brain stem CT number of the 14 patients for pre-treatment and re-plan was 28.7 cm3 and 28.9 cm3 ( P = 0.887) separately.Conclusion After the treatment of 20 fractions, the volume of the parotid was significantly shrinked, the CT number was significantly decreased and the SD of CT number was significantly increased. The volume, CT number and SD of the Brain stem did not have significant changes. The change of the CT number could be a new observed data for the adaptive plan during the treatment as the tumor response.
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Key words:
- Nasopharyngeal cancer /
- Parotid /
- CT number change /
- Radiotherapy
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