Dynamic Observation and Clinical Analysis of Tumor Volume Changes during Radiotherapy for Non-small Cell Lung Cancer_West China Medical Journal

Authors：

LIU Yongmei ¹ , DING Zhenyu ¹ , ZHONG Renming ² , JIANG Xiaoqin ² , XU Qingfeng ² ,  LI Ping. ³

1. Department of Thoracic Oncology; 2. Division of Physics Center; 3. Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Ping., Email: lymi75@163.com

Keywords：

非小細胞肺癌; 錐形束CT; 腫瘤體積

DOI：

10.7507/1002-0179.20130055

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目的　通過非小細胞肺癌（NSCLC）圖像引導放射治療（IGRT）過程中，每次治療前獲取的錐形束CT圖像，動態觀察腫瘤體積的變化。方法　2009年2月－2010年8月18例周圍型NSCLC患者接受IGRT。每次治療前進行千伏級錐形束CT（KV-CBCT）圖像的采集。每周在KV-CBCT圖像上勾畫腫瘤靶區并計算靶區體積，經統計后分析腫瘤治療過程中體積的變化。結果　治療開始時平均體積為28.5 cm3（2.5～109.1 cm3），治療結束時平均體積為17.1 cm3 （1.4～73.4 cm3）。平均退縮率為35.9%（3.9%～68.9%），平均每天的退縮率為1.5% （0.1%～5.4%）。治療結束時，0例病灶完全消退，1例部分消退，10例微小消退，7例穩定。結論　治療過程中，NSCLC腫瘤的退縮可以通過KV-CBCT進行觀察。當病灶為周圍型時，能對腫瘤體積的變化進行客觀有效的評價。放射治療過程中腫瘤的體積改變具有很大的異質性，腫瘤在治療過程中體積均有一定的退縮，但治療結束時大多數病灶僅為微小消退或穩定。

Citation： LIU Yongmei,DING Zhenyu,ZHONG Renming,JIANG Xiaoqin,XU Qingfeng,LI Ping.. Dynamic Observation and Clinical Analysis of Tumor Volume Changes during Radiotherapy for Non-small Cell Lung Cancer. West China Medical Journal, 2013, 28(2): 167-171. doi: 10.7507/1002-0179.20130055 Copy

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8.	Kim DW, Shyr Y, Chen H, et al. Response to combined modality therapy correlates with survival in locally advanced non-small-cell lung Cancer[J]. Int J Radiat Oncol Biol Phys, 2005, 63(4): 1029-1036.
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11.	張英杰, 李建斌, 于金明, 等. CBCT影像引導非小細胞肺癌三維適形放療靶區位置及體積變化分析[J]. 中華放射醫學與防護雜志, 2008, 28(6): 626-627.
12.	Britton KR, Starkschall G, Tucker SL, et al. Assessment of gross tumor volume regression and motion changes during radiotherapy for non-small-cell lung Cancer as measured by four-dimensional computed tomography[J]. Int J Radiat Oncol Biol Phys, 2007, 68(4): 1036-1046.
13.	Guckenberger M, Richter A, Wilbert J, et al. Adaptive radiotherapy for locally advanced non-small-cell lung Cancer does not underdose the microscopic disease and has the potential to increase tumor control[J]. Int J Radiat Oncol Biol Phys, 2011, 81(4): 275-282.
14.	陳龍, 謝小妹, 黃江瓊, 等. 非小細胞肺癌自適應放療劑量學研究[J]. 中國癌癥防治雜志, 2012, 4(1): 53-56.

1. 　Mcbain CA, Henry AM, Sykes J, et al. X-ray volumetric imaging in image-guided radiotherapy: the new standard in on-treatment imaging[J]. Int J Radiat Oncol Biol Phys, 2006, 64(2): 625-634.
2. 　Mackie TR, Kapatoes J, Ruchala K, et al. Image guidance for precise conformal radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2003, 56(1): 89-105.
3. 　Chappell RJ, Miranpuri SS, Mehta MP. The importance of dimension in defining tumor response[J]. J Clin Oncol, 1998, 16(3): 1234.
4. 　Schulz CA, Miranpuri SS, Chappell RJ, et al. Comparison of methods for response analysis of central nervous system neoplasms[J]. Int J Radiat Oncol Biol Phys, 1998, 42(1): 261.
5. 　Scrimger RA, Tomé WA, Olivera GH, et al. Reduction in radiation dose to lung and other normal tissues using helical tomotherapy to treat lung Cancer, in comparison to conventional field arrangements[J]. Am J Clin Oncol, 2003, 26(1): 70-78.
6. 　Kron T, Grigorov G, Yu E, et al. Planning evaluation of radiotherapy for complex lung Cancer cases using helical tomotherapy[J]. Phys Med Biol, 2004, 49(16): 3675-3690.
7. 　Willner J, Baier K, Caragiani E, et al. Dose, volume, and tumor control prediction in primary radiotherapy of non-small-cell lung Cancer[J]. Int J Radiat Oncol Biol Phys, 2002, 52(2): 382-389.
8. 　Kim DW, Shyr Y, Chen H, et al. Response to combined modality therapy correlates with survival in locally advanced non-small-cell lung Cancer[J]. Int J Radiat Oncol Biol Phys, 2005, 63(4): 1029-1036.
9. 　Kupelian PA, Ramsey C, Meeks SL, et al. Serial megavoltage CT imaging during external beam radiotherapy for non-small-cell lung Cancer: observations on tumor regression during treatment[J]. Int J Radiat Oncol Biol Phys, 2005, 63(4): 1024-1028.
10. 　Siker ML, Tomé WA, Mehta MP. Tumor volume changes on serial imaging with megavoltage CT for non-small-cell lung Cancer during intensity-modulated radiotherapy: how reliable, consistent, and meaningful is the effect?[J]. Int J Radiat Oncol Biol Phys, 2006, 66(1): 135-141.
11. 　張英杰, 李建斌, 于金明, 等. CBCT影像引導非小細胞肺癌三維適形放療靶區位置及體積變化分析[J]. 中華放射醫學與防護雜志, 2008, 28(6): 626-627.
12. 　Britton KR, Starkschall G, Tucker SL, et al. Assessment of gross tumor volume regression and motion changes during radiotherapy for non-small-cell lung Cancer as measured by four-dimensional computed tomography[J]. Int J Radiat Oncol Biol Phys, 2007, 68(4): 1036-1046.
13. 　Guckenberger M, Richter A, Wilbert J, et al. Adaptive radiotherapy for locally advanced non-small-cell lung Cancer does not underdose the microscopic disease and has the potential to increase tumor control[J]. Int J Radiat Oncol Biol Phys, 2011, 81(4): 275-282.
14. 　陳龍, 謝小妹, 黃江瓊, 等. 非小細胞肺癌自適應放療劑量學研究[J]. 中國癌癥防治雜志, 2012, 4(1): 53-56.

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Dynamic Observation and Clinical Analysis of Tumor Volume Changes during Radiotherapy for Non-small Cell Lung Cancer

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