| 龚艳萍,钱建军.小细胞肺癌全脑预防性照射中腮腺限量降低正常组织并发症概率[J].肿瘤学杂志,2019,25(1):36-41. |
| 小细胞肺癌全脑预防性照射中腮腺限量降低正常组织并发症概率 |
| Reduction of Normal Tissue Complication Probability by Limiting Dose of Parotid Gland in Prophylactic Cranial Irradiation for Small Cell Lung Cancer |
| 投稿时间：2017-08-15 |
| DOI：10.11735/j.issn.1671-170X.2019.01.B009 |
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| 中文关键词: 小细胞肺癌 全脑预防性照射 腮腺 正常组织并发症概率 |
| 英文关键词:small cell lung cancer prophylactic cranial irradiation parotid gland normal tissue complication probability |
| 基金项目:苏州市科技发展计划(SZS201509)；江苏省科技厅临床医学科技专项（BL2014040） |
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| 中文摘要: |
| 摘 要：［目的］ 在小细胞肺癌患者全脑预防性照射（PCI）中通过限制腮腺的剂量来降低其正常组织并发症概率（NTCP），为全脑放疗中腮腺的保护提供依据。［方法］ 选择行PCI照射的SCLC患者24例，勾画腮腺轮廓作为危及器官（OAR），按照腮腺不同限量程度分别设计2D、2D_M和IMRT三种计划并评估其剂量体积和NTCP。［结果］ 24例患者两侧腮腺体积平均为（36.04±4.41）cc。其中左侧腮腺（17.89±3.86）cc、右侧腮腺（18.15±4.41）cc；三种技术（2D、2D_M和IMRT）的T腮腺生物等效剂量（BETD）平均值分别为(1684±416)cGy、(1210±366)cGy和(839±128)cGy。在T2D技术腮腺不限量时有10例患者（41.67%）存在超量情况，其中左右两侧腮腺各有7个（29.17%）超过了2000cGy，并且各有2个（8.33%）超过了2500cGy。2D_M技术中仅有1例患者（4.16%）的单侧腮腺BED>2000cGy（2023cGy），而IMRT技术中则无超量腮腺T。三种技术的NTCP平均分别为（5.08±2.56）%、（3.12±1.42）%和（1.91±0.40）%，腮腺限量后其NTCP明显降低（P均<0.001）。 ［结论］ 在小细胞肺癌全脑预防性照射中不保护腮腺可能会导致其毒副反应的发生，在治疗计划设计中通过腮腺限量可以有效降低其正常组织并发症概率。 |
| 英文摘要: |
| Abstract：［Objective］ To reduce the normal tissue complication probability(NTCP) in prophylactic cranial irradiation(PCI) for small cell lung cancer(SCLC)，and to provide evidence for sparing of parotid in whole brain radiation therapy. ［Methods］ Twenty-four SCLC patients receiving PCI were recruited. Parotids were delineated and three plans named as 2D，2D_M and IMRT were designed according to different degree of dose limiting on parotid，subsequently the parotid dose volume and NTCP were evaluated. ［Results］ The mean total parotids volume was(36.04±4.41)cc，that of left and right parotid was(17.89±3.86)cc and(18.15±4.41)cc，respectively. The mean value of biological equivalent dose(BED) of parotids in plans 2D，2D_M and IMRT was(1684±416)cGy，(1210±366)cGy and(839±128)cGy，respectively. For 2D plans in which the parotids were not spared，the dose of parotids was excess in 10 patients(T41.67%T)，including the dose of right and left parotid was >2000cGy in 7(29.17%) and >2500cGy in 2(8.33%); for 2D_M only 1 patients(4.16%) whose dose of unilateral parotid was >2000cGy; while there was no dose excess in IMRT. The average NTCP of the three plans were(5.08 ±2.56)%，(3.12±1.42)% and(1.91±0.40)%(P<0.05). ［Conclusion］ Normal tissue complication probability of parotid can be effectively reduced by limiting its dose in prophylactic cranial irradiation for patients with small cell lung cancer. |
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