IGRT和ART在頭頸惡性腫瘤放療中的重要地位課件

IGRT&ART在頭頸惡性腫瘤放療中的重要地位2014.05.24武漢張碩頭頸部惡性腫瘤綜合治療的必要性個(gè)體化治療在頭頸惡性腫瘤放療中的重要地位頭頸部惡性腫瘤治療的熱點(diǎn)——靶向治療頭頸部惡性腫瘤治療的難點(diǎn)——提高生活質(zhì)量心得病毒及基因檢測(cè)判斷治療的預(yù)后為個(gè)體化治療提供理論依據(jù)影像學(xué)引導(dǎo)在放療計(jì)劃正確實(shí)施中的重要作用個(gè)體化治療在頭頸惡性腫瘤放療中的重要地位SBRTBodyPro-Lok組合式全身定位系統(tǒng)

定位圖像重要性ImagecapturesfromdailytreatmentCT(CTonrail):Cordcontoursfrommultipledaysareoverlappedononesamplesagitalimage.Thepoormatchingofdailycontoursillustratesthesetupproblemforheadandneckpatients.Wood,etal.,AnnualmeetingofASTROinSeptember2008,Boston,MA.IGRT——擺位誤差擺位誤差——IGRT重要性放療始放療20次擺位誤差——IGRT重要性放療始放療20次擺位誤差——以脊髓為基準(zhǔn)Whenusingmandiblebasedalignment,weconsidertherelationshipbetweenmandibleandPTV(GTV)tobefixed,sotheDVHsofoverlappingpartshouldhaveverygoodagreementWhenusingcordalignment,weconsidertherelationshipbetweencordandPTV(GTV)tobefixed,wheretherelationshipbetweenmandibleandPTV(GTV)maychange.SotheoverlappingregionshowsslightdifferenceandtheDVHsofoverlappingpartshouldshowalsoslightlydifferenceCordCordMandibleMandibleOverlapping*Overlapping*GTVPTVPTVGTV*DVHbasedonoverlappingvolumesofPTVanddailymandiblecontours擺位誤差——DVH衡量自適應(yīng)放射治療（ART)Anexampleofincreasingroominsideathermoplasticfacemaskbecauseoftumorshrinkageandweightlossastreatmentprogresses.planningFirstfraction(oneweekafterCetuximab)Fraction22自適應(yīng)放射治療的重要性體重減輕——自適應(yīng)放射治療重要性放療始放療15次體重減輕——自適應(yīng)放射治療重要性腫瘤縮小——自適應(yīng)放射治療重要性GTV——放療始——放療20次CT——放療20次MRIGTVL——放療始——放療20次CTSBRTBodyPro-lok組合式全身定位系統(tǒng)在頭頸部腫瘤的放