Kantzou I, Kelekis N, Platoni K, Sandilos P, Gouliamos A, Kouvaris I, Kouloulias V
Kapodistrian University of Athens, Medical School, 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Athens, Greece.
J BUON. 2010 Oct-Dec;15(4):684-9.
radiotherapy is widely used to treat patients with prostate cancer. Using conventional x-ray simulation is often difficult to accurately localize the extent of the tumor, to cover exactly the lymph nodes at risk and shield the organs at risk. We report the initial results of a study conducted to compare target localization with conventional and virtual simulation.
fifty patients with prostate cancer underwent target localization for radical prostate radiotherapy using conventional and virtual simulation. The treatment fields were initially marked with a conventional portal film on LINAC, plain x-ray film and available diagnostic imaging. Each patient then had a computed tomography (CT) and these simulated treatment fields were reproduced within the virtual simulation planning system. The treatment fields defined by the clinicians using each modality were compared in terms of field area and implications for target coverage.
there was significantly greater clinical tumor volume coverage using virtual simulation compared with conventional simulation and less normal tissue volume irradiated (p<0.001).
CT localization and virtual simulation allow for more accurate definition of the clinical target volume. This could enable a reduction in geographical misses, while also reducing treatment-related toxicity.
放射疗法被广泛用于治疗前列腺癌患者。使用传统的X射线模拟往往难以准确地定位肿瘤范围，难以精确覆盖有风险的淋巴结并保护有风险的器官。我们报告了一项旨在比较传统模拟与虚拟模拟在靶区定位方面的研究的初步结果。
50例前列腺癌患者接受了使用传统模拟和虚拟模拟进行的根治性前列腺放疗靶区定位。治疗野最初在直线加速器上用传统的射野片、普通X线片和现有的诊断影像进行标记。然后对每位患者进行计算机断层扫描（CT），并在虚拟模拟计划系统内重现这些模拟治疗野。比较临床医生使用每种方式定义的治疗野的野面积以及对靶区覆盖的影响。
与传统模拟相比，虚拟模拟的临床肿瘤体积覆盖率显著更高，而正常组织受照射体积更小（p<0.001）。
CT定位和虚拟模拟能够更准确地定义临床靶区体积。这可以减少靶区遗漏，同时降低与治疗相关的毒性。
