头颈部肿瘤IMRT中适应性再计划预测因素和时间节点的研究进展

摘要

在头颈部肿瘤IMRT疗程中,适应性再计划有助于改善由于解剖结构变化导致的剂量学不确定性,并能提高患者的局部控制率和生活质量.研究表明患者治疗前有较大淋巴结、治疗中体重明显下降等是疗程中再计划的重要预测因素;在放疗开始第4周后靶区及危及器官的缩小趋于稳定,建议第3或第4周行1～2次适应性再计划.%Adaptive re-planning contributes to improve the dosimetric uncertainties induced by anatomical changes during intensity-modulated radiation therapy (IMRT) for head and neck cancer patients and can enhance the local control rate and quality of life of patients.Previous research has demonstrated that presence of relatively large lymph nodes before treatment and significant loss of body weight during treatment are pivotal predictive factors of re-planning during IMRT.At 4 weeks after IMRT,the volume of the target and peripheral organ at risk (OAR) tends to steadily decrease.One to two cycles of adaptive re-planning are recommended at 3 or 4 weeks after IMRT.