摘要
目的探讨肺鳞癌^(125)Ⅰ粒子植入术后各剂量参数与肿瘤体积缩小比的关系,并得出预测疗效的最佳参数。方法回顾性分析2015年1月至2021年3月本院^(125)Ⅰ粒子植入治疗的26例肺鳞癌患者,共28个病灶。所有患者术后即刻行剂量验证,得出术后D_(90)(90%靶体积所接受的最小周边剂量)。术后规律随访,根据患者实际随访时的CT图像计算术后t个月肿瘤体积缩小比(R_(t))、术后1个月肿瘤体积缩小比(R_(1))、初月理论吸收剂量(D_(1m))、初月疗效校正吸收剂量(D_(1e))和初月敏感性校正吸收剂量(D_(1s))。将术后D90与R1进行曲线拟合,将术后D_(90)、D_(1m)、D_(1e)、D_(1s)与R_(t)进行曲线拟合,寻找各参数与肿瘤体积缩小比的关联性。结果术后D_(90)、D_(1m)、D_(1e)、D_(1s)、R_(t)和R_(1)分别为(113.56±27.61)Gy、(35.2±9.8)Gy、(45.8±17.9)Gy、(38.6±20.7)Gy、(34±39)%和(27±27)%。术后D_(90)与R_(1),术后D_(90)、D_(1m)、D_(1e)、D_(1s)与R_(t)均为正相关,关系方程分别为y=0.00001x^(2)+0.0019x-0.1331(R^(2)=0.234)、y=-0.0001x^(2)+0.0292x-1.4459(R^(2)=0.210)、y=0.5222lnx-1.4938(R^(2)=0.161)、y=-0.0004x^(2)+0.0489x-0.9973(R^(2)=0.503)和y=0.3909lnx-1.0304(R^(2)=0.287)。结论术后D_(90)、D_(1m)、D_(1e)、D_(1s)与术后肿瘤体积缩小比呈正相关,可用于预测肺鳞癌^(125)Ⅰ粒子植入患者的疗效,相较于术后D_(90)和D_(1m),D_(1e)与D_(1s)预测疗效可能更优。
Objective To investigate the relationship between dosimetric parameters and tumor volume reduction ratio after ^(125)Ⅰ seed implantation in lung squamous cell carcinoma,and to obtain the best parameters to predict the curative effect.Methods From January 2015 to March 2021,26 patients with lung squamous cell carcinoma treated with ^(125)Ⅰ seed implantation in Hebei General Hospital were analyzed retrospectively,with a total of 28 lesions.All patients underwent dose verification immediately after operation.The postoperative D_(90)(the minimum peripheral dose accepted by 90%of the target volume)was obtained.The patients were followed up regularly.The tumor volume reduction ratio t months after operation(R_(t)),tumor volume reduction ratio 1 month after surgery(R_(1)),theoretically absorbed dose at 1 month(D_(1m)),curative effect-corrected absorbed dose at 1 month(D_(1e))and sensitivity-corrected absorbed dose at 1 month(D_(1s))were calculated according to the CT images during the actual follow-up.Curve fitting was performed for postoperative D_(90) and R_(1),and curve fitting was performed for postoperative D_(90),D_(1m),D_(1e),D_(1s) and R_(t) to find the correlation between each parameter and tumor volume reduc-tion ratio.Results The values of postoperative D_(90),D_(1m),D_(1e),D_(1s),R_(t),and R_(1) were(113.56±27.61)Gy,(35.2±9.8)Gy,(45.8±17.9)Gy,(38.6±20.7)Gy,(34±39)%,and(27±27)%,respectively.Postoperative D90 and R1 was positively correlated,postoperative D_(90),D_(1m),D_(1e),D_(1s) and R_(t) were also positively correlated.The corresponding equations were y=0.00001x^(2)+0.0019x-0.1331(R^(2)=0.234),y=-0.0001x^(2)+0.0292x-1.4459(R^(2)=0.210),y=0.5222lnx-1.4938(R^(2)=0.161),y=-0.0004x^(2)+0.0489x-0.9973(R^(2)=0.503),and y=0.3909lnx-1.0304(R^(2)=0.287).Conclusions Postoperative D_(90),D_(1m),D_(1e) and D_(1s) are positively correlated with the postoperative tumor volume reduction ra-tio,which can be used to predict the curative effect of ^(125)Ⅰ seed implantation in patients with lung squamous cell carcinoma.Compared with postoperative D_(90) and D_(1m),D_(1e) and D_(1s) may be better in predicting curative effect.
作者
徐克
于慧敏
陈恩立
赵金鑫
刘泽洲
李慧娟
王娟
张宏涛
Xu Ke;Yu Huimin;Chen Enli;Zhao Jinxin;Liu Zezhou;Li Huijuan;Wang Juan;Zhang Hongtao(Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center,Hebei Provincial Radioactive Seeds Brachytherapy Institute,Department of Oncology,Hebei General Hospital,Shijiazhuang 050051,China)
出处
《实用肿瘤杂志》
CAS
2023年第3期245-250,共6页
Journal of Practical Oncology
基金
河北省重点研发计划项目(19277767D)。
关键词
肺鳞癌
^(125)Ⅰ粒子
剂量
疗效
近距离治疗
lung squamous cell carcinoma
^(125)Ⅰ seed
dose
therapeutic effect
brachytherapy
