Kỹ thuật xạ trị điều biến liều thích ứng hai pha ở bệnh nhân ung thư đầu cổ tại Bệnh viện Quân y 103

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Tác giả: Thùy Linh Dương, Thị Định Lại, Châu Phong Nguyễn, Thị Hoan Phạm, Văn Tôn Trần, Viết Đức Trần, Thanh Tùng Vũ

Ngôn ngữ: vie

Ký hiệu phân loại: 571.45 *Radiobiology

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 506-512

Bộ sưu tập: Metadata

ID: 500664

Thêm vào giỏ

Nghiên cứu sự thay đổi các thông số của thể tích xạ trị và các tổ chức lành khi áp dụng kỹ thuật xạ trị điều biến liều thích ứng 2 pha ở bệnh nhân ung thư đầu cổ. Đối tượng và phương pháp nghiên cứu: Nghiên cứu can thiệp lâm sàng tiến cứu mô tả trên 27 bệnh nhân ung thư đầu cổ xạ trị điều biến liều triệt căn tại Bệnh viện Quân Y 103 từ tháng 01/2022 đến tháng 06/2022. Kết quả: Sau 30Gy thể tích u nguyên phát pha 2 giảm ở 81,49% số bệnh nhân so với pha 1, mức giảm trung bình 18,18 ± 12,98 cc (p = 0,027). Có 82,25% số hạch tại pha 2 giảm thể tích so với pha 1 (p = 0,031). Nếu không lập kế hoạch xạ trị thích ứng pha 2 sẽ làm giảm liều hấp thu tại các thể tích xạ trị thô ở 88,89% số bệnh nhân. Tuyến nước bọt mang tai 2 bên có sự thay đổi thể tích có ý nghĩa (p = 0,03), mức giảm thể tích trung bình của pha 2 so với pha 1 là 6,21 ± 0,76cc. Không lập kế hoạch xạ trị thích ứng pha 2 sẽ làm tăng liều cực đại tại tuyến nước bọt mang tai 11,99 ± 1,11Gy (p = 0,01 ) và tủy sống 4,61 ± 1,23Gy( p= 0,04). Kết luận: Kỹ thuật xạ trị điều biến liều thích ứng 2 pha điều chỉnh liều hấp thụ tại các thể tích đích và cơ quan lành thích ứng với sự thay đổi thể tích trong quá trình xạ trị, nâng cao hiệu quả tiêu diệt tế bào ung thư cũng như bảo vệ tối đa các tổ chức lành.To study the change of parameters of radiotherapy volume and organs at risk when applying 2 phases adaptive plan- Intensity Modulated Radiation Therapy (IMRT) technique in head and neck cancer patients. Subjects and research methods: A prospective descriptive clinical intervention study on 27 head and neck cancer patients undergoing definitive IMRT treatment at 103 Military Hospital from January 2022 to June 2022. Results: After 30Gy, the primary tumor volume in phase 2 decreased in 81.49% of patients compared with phase 1, the average reduction was 18.18 ± 12.98cc (p = 0.027). There were 82.25% of lymph nodes in phase 2 decreased in volume compared to phase 1 (p = 0.031). Failure to second phase adaptive plan IMRT will reduce the absorbed dose at crude radiotherapy volumes in 88.89% of patients. Bilateral parotid salivary glands have a significant volume change (p = 0.03), the average volume reduction of phase 2 compared with phase 1 is 6.21 ± 0.76cc. Failure to second phase adaptive plan radiation therapy resulted in an increase in the maximal dose at the parotid salivary glands by 11.99 ± 1.11Gy (p = 0.01) and the spinal cord by 4.61 ± 1.23Gy (p = 0.04). Conclusion: The 2-phase adaptive plan IMRT technique adjusts the absorbed dose at target volumes and organs at risk adapt to volume changes during radiation therapy, improving the efficiency of killing cancer cell as well as maximum protection of organs at risk.

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