摘要
目的探讨胰腺占位性病变的运动规律及其影响因素,为其在精确放疗时确定PTV的安全边界提供参考价值。方法16例胰腺癌患者采用B超引导下穿刺的方法将1~2个纯金标记(fiducial)植入胰腺肿瘤体内,并在模拟定位机下对标记的运动幅度进行测量,得出其在患者身体左右(z轴)、前后(Y轴)、头脚(z轴)方向的移动数据。用多元线性回归模型分析影响因素。结果测量结果显示16例患者在z轴方向的移动距离为0.1~0.3cm[(0.16±0.06)cm],2轴方向为0.5~1.6cm[(0.88±0.24)cm],Y轴方向为0.1~0.4cm[(0.25±0.12)cm]。其移动距离与患者年龄、身高、体重、肿瘤位置和大小无关。结论胰腺占位性病变的移动主要受呼吸运动影响,且在z轴方向的移动距离最大,在确定PTV安全边界时应主要考虑其在:轴方向的移动。
Objective To investigate the movement and its influencing factors of the space-occupying pancreatic lesions and provide a reference for the safe margin between CTV and PTV in accurate radiotherapy. Methods Gold fiducials were implanted into the lesions of 16 pancreatic carcinoma patients by percutaneous punctures under B-uhrasonographic guidance. The movements of these markers were measured under the X-ray simulator system in the x, y and z axial directions, respectively. The relevant influencing factors were analyzed. Results The motion amplitudes of pancreatic lesions were 0.1 - 0.3 ( mean 0.16±0.06) cm,0. 1 -0.4 (mean 0.25±0. 12) cm and 0.5 - 1.6 (mean 0. 88±0.24) em in the x,y and z axial directions, respectively. The movements were not associated with the height, weight, age, tumor location or tumor size. Conclusions The motion of the space-occupying pancreatic lesions is mainly influenced by the respiration, especially with the maximal amplitude in the z axial direction. Therefore, the motion in the z axial direction should be given more consideration when determining the PTV margin.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2009年第1期15-18,共4页
Chinese Journal of Radiation Oncology
关键词
占位病变
胰腺
移动距离
影响因素
Space-occupying lesion, Pancreas
Motion distance
Influencing factor