祖国红,孙美丽,张 健,苏 晨,汪延明

目的：针对NSCLC SBRT患者采用腹部加压联合4D-CT呼吸管理技术，从而对计划精度影响进行了观察分析。方法：采用2021年10月以来我科收入NSCLC SBRT病例，随机选择15例，分为二组，4D-AC(4-Dimensional CT Abdominal Compression）组采用腹部加压扫描4D-CT图像，4D-FB(4-Dimensional CT Free Breath)组扫描4D-CT图像，对10个呼吸时相勾画GTV,利用最大密度投影融合形成肿瘤内靶区（Internal target volume ITV），分别为IGTV-AC,IGTV-FB,设计计划，对危机器官的体积和剂量进行记录统计。结果：⑴两组患者内靶区中位体积IGTV-AC、IGTV-FB分别为：4.15±0.50、5.42±0.81，IGTV-AC明显小于IGTV-FB,有显著差异(P<0.05)；适形指数（Conformal index、CI)、剂量梯度指数（Dose Gradient index GI)无统计学意义；两组患肺V5、V20、平均剂量（Mean Lung Dose MLD）分别为：14.18±2.09、19.60±4.70；3.85±0.87、6.86±0.31；2.75±0.39、3.47±0.38；4D-AC组患者均明显低于4D-FB组患者，有显著差异(P＜0.05)；心脏受照体积及剂量略有减少，无统计学意义。结论：在NSCLC SBRT计划设计中，腹部加压管理干预呼吸的4D-AC组较自由呼吸模式下的4D-FB组能有效减小靶区及危机器官体积剂量。

4D-CT；腹部加压；非小细胞肺癌 SBRT 治疗；计划精度影响分析

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