Fukumitsu Nobuyoshi, Ishikawa Hitoshi, Ohnishi Kayoko, Terunuma Toshiyuki, Mizumoto Masashi, Numajiri Haruko, Aihara Teruhito, Okumura Toshiyuki, Tsuboi Koji, Sakae Takeji, Sakurai Hideyuki
Proton Medical Research Center, University of Tsukuba, Japan.
Proton Medical Research Center, University of Tsukuba, Japan.
Radiother Oncol. 2014 Oct;113(1):72-6. doi: 10.1016/j.radonc.2014.08.024. Epub 2014 Sep 19.
Aeration in the nasal cavity and paranasal sinus (NCPS) was investigated during the course of proton therapy (PT), and the influence of aeration on the dose distribution was determined.
Twenty patients with NCPS cancer (10 nasal cavity, 10 paranasal sinus) were analyzed. All the patients received a total proton beam irradiation dose of 38-78.4 Gray equivalents (GyE). Two to five CT examinations were performed during the course of treatment. The aeration ratio inside the cavity/sinus was calculated for each CT observation. Moreover, a simulation study supposing that the first treatment plan had been continued until the end of treatment was performed using the subsequent CT findings.
The aeration ratio was increased in 18 patients. The largest increase was from 15% to 82%. Three patients had a simulated maximum cumulative dose in the brainstem of beyond 60 GyE, while 10 patients had a simulated maximum cumulative dose in the optic chiasm of beyond 50 GyE. The shortest simulated time period to reach the dose limitation was 21 days.
Aeration in the NCPS is altered during the course of PT treatment and can greatly alter the dose distribution in the brainstem and optic chiasm.
在质子治疗（PT）过程中对鼻腔和鼻窦（NCPS）的通气情况进行了研究，并确定了通气对剂量分布的影响。
分析了20例NCPS癌症患者（10例鼻腔癌、10例鼻窦癌）。所有患者接受的质子束总照射剂量为38 - 78.4格雷当量（GyE）。在治疗过程中进行了2至5次CT检查。针对每次CT观察计算腔内/鼻窦内的通气率。此外，利用后续CT结果进行了一项模拟研究，假设第一个治疗计划持续到治疗结束。
18例患者的通气率有所增加。最大增幅从15%至82%。3例患者脑干模拟最大累积剂量超过60 GyE，10例患者视交叉模拟最大累积剂量超过50 GyE。达到剂量限制的最短模拟时间段为21天。
在PT治疗过程中，NCPS的通气情况会发生改变，并且会极大地改变脑干和视交叉处的剂量分布。
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