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MR引导的海马保护用于小细胞肺癌全脑放疗

Hippocampal avoidant whole brain radiotherapy guided by MR of small cell lung cancer

来源期刊: 广州医药 | 330-337 发布时间:2025-04-08 收稿时间:2025/11/13 18:54:28 阅读量:35
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小细胞肺癌海马放疗MR引导技术
small cell lung cancerhippocampusradiation therapyMR guided technology
DOI:
10.20223/j.cnki.1000-8535.2025.03.006
收稿时间:
2024-03-18 
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0  
目的 研究核磁共振(MR)引导的海马保护技术应用于小细胞肺癌全脑放射治疗(放疗)的效果。方法 对确定行全脑放疗的30例小细胞肺癌脑转移患者,行常规放疗CT定位后以定位体位行全头颅MR平扫,将计算机断层扫描(CT)和MR的T1加权像在Monaco 5.1计划系统上进行精准融合,勾画全脑放疗及海马区域,在海马区域三维方向上分别外扩5、15 mm作为海马与计划靶区之间的剂量跌落,每一例患者在Monaco 5.1计划系统上按照不保护海马组织以及外扩5、15 mm进行保护设计3个容积旋转调强技术(VMAT)放疗计划,观察海马组织的平均及最大放疗剂量。结果 增加保护海马组织之后,3个放疗计划的D100均≥95%,每例的3个放疗计划间D100比较差异无统计学意义(P>0.05);设置外扩5、15 mm的剂量跌落区后,左、右海马的平均剂量、最大剂量均明显降低,而且3个放疗计划的海马平均剂量、最大剂量之间对比差异有统计学意义。结论 小细胞肺癌脑转移患者进行全脑放疗时,利用MR引导的海马保护技术并设置外扩15 mm的剂量跌落区,能够显著降低海马的剂量,达到保护目的。
Objective To explore the application of MR guided hippocampal avoidant whole brain radiotherapy(WBRT)for small cell lung cancer(SCLC).Methods Thirty SCLC patients with brain metastases who underwent WBRT were enrdled.After routine CT localization was performed,and a head MR was performed in a the same position.T1 weighted images of MR and CT images were accurately fused on the Monaco 5.1 planning system.The entire brain tissue and hippocampus region were delineated. The dose drop areas between the hippocampus and the planned target area were expanded 5mm and 15mm in the three-dimensional direction of the hippocampus,respectively.Three volumetric modulated arc therapy(VMAT)radiotherapy plans were designed for each patient on the Monaco 5.1 planning system based on whether the hippocampal tissue was avoid.The average and maximum doses of hippocampal tissue were observed.Results After the avoidance of hippocampal tissue,the D100 of the three radiotherapy plans reached ≥95%,and there was no significant difference in D100 between the three radiotherapy plans in each case.After setting dose drop areas of 5mm and 15mm for external expansion,the average and maximum doses of the left and right hippocampus were significantly reduced,and there was a significant difference in the comparison between the average and maximum doses in the hippocampus of the three radiotherapy plans.Conclusions MR guided hippocampal avoidant technology and the setting of a 15 mm dose drop area can significantly reduce the dose to the hippocampus in patients with SCLC undergo whole brain radiotherapy.
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