摘要
目的探讨肿瘤体积的变化在肿瘤寡病灶放射治疗(放疗)疗效评估中的应用。方法 31例原发性或转移性肺癌患者放疗结束后1个月,测量肿瘤体积的变化以评估肿瘤寡病灶放疗疗效。在Pinnacle治疗计划系统上勾画出治疗前后肿瘤靶区,直接读取病灶体积。同时测量治疗前后病灶的最大直径。病灶最大直径或体积减少大于30%设定为部分缓解(PR),病灶最大直径或体积增加小于20%设定为疾病稳定(SD)。治疗前后最大直径减少率与体积减少率的相关性分析采用Pearson直线相关分析,采用线性回归分析拟合直线回归方程。结果全组用直径的变化评估疗效达PR者6例,SD者25例;用体积的变化评估疗效达PR者22例,SD者9例;两种方法比较差异有统计学意义(χ~2=16.67,P<0.01)。进一步分层分析发现,肿瘤形态规则组用体积的变化评估放疗疗效较不规则组更优(回归系数1.548vs.1.178);常规分割组用体积的变化评估放疗疗效较大分割组略优(回归系数1.465vs.1.321)。结论肿瘤体积变化评估肿瘤寡病灶的放疗疗效较直径变化可能更为精确。
Objective To investigate the application of tumor volume changes in radiotherapy efficacy evaluation for solitary tumor lesion.Methods Thirty-one patients with primary or metastatic lung cancer were treated with radiotherapy and the efficacy was evaluated in one month after radiotherapy by measuring tumor volume changes.On the Pinnacle treatment planning system,the lesion volume was outlined and read directly.At the same time the maximum lesion diameter was measured before and after radiotherapy.The reduction of maximum lesion diameter or lesion volume greater than 30% was defined as partial response(PD),and the increase of maximum lesion diameter or lesion volume less than 20% was defined as stable disease(SD).The correlation between maximum diameter reduction rate and volume reduction rate before and after radiotherapy was analyzed using Pearson linear correlation analysis.Linear regression analysis was used to fit linear regression equation.Results There were 6 cases with PR and 25 cases with SD after radiotherapy according to the lesion diameter change.In contrast,there were 22 cases with PR and 9 cases with SD after radiotherapy according to the lesion volume change(χ~2=16.67,P<0.01).Further analysis showed that the radiotherapy efficacy evaluation using lesion volume change in regular group was better than that in irregular group(regression coefficient 1.548 vs.1.178),which in conventional segmentation group was slightly better than that in large segmentation group(regression coefficient 1.465 vs.1.321).Conclusion Radiotherapy efficacy evaluation for solitary tumor lesions by lesion volume change may be more accurate than that by lesion diameter change.
作者
殷海涛
周冲
任洪荣
张璐
YIN Haitao;ZHOU Chong;REN Hongrong(Department of Radiotherapy,Xuzhou Central Hospital,Xuzhou 221009,CHINA)
出处
《江苏医药》
CAS
2018年第12期1404-1407,共4页
Jiangsu Medical Journal
基金
江苏省六大人才高峰项目(2014-WSN-069)
徐州市医学青年后备人才项目(2014005)
关键词
肿瘤
寡病灶
放射治疗
Tumor
Solitary lesion
Radiotherapy
作者简介
通信作者:张璐E-mail:luzhu740408@163.com.
