早期非小细胞肺癌立体定向放射治疗指南

doi:10.3760/cma.j.cn371439-20210621-00001

摘要/Abstract

摘要：

中国医师协会放射肿瘤治疗医师分会. 早期非小细胞肺癌立体定向放射治疗指南[J]. 国际肿瘤学杂志, 2022, 49(1): 1-11.

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参考文献 32

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分型	适应证	剂量及分次	参考来源
周围型	小病灶(<2 cm),GTV距胸壁>1 cm	34 Gy/1 F	RTOG 0915
	PTV不紧贴胸壁时	5460 Gy/3 F^a	RTOG 0618和RTOG 0236
		6066 Gy/3 F	参考文献[12,13]
		45 Gy/3 F	参考文献[14]
	PTV紧邻或与胸壁重叠时	4860 Gy/45 F^b	RTOG 0915/参考文献[13]
中央型	PTV在中央或毗邻中央区内,但在超中央区外	5060 Gy/5 F	RTOG 0813
		50 Gy/4 F或70 Gy/10 F	参考文献[15]
		60 Gy/8 F	参考文献[13]
	PTV超中央型的区域内	5060 Gy/810 F^c	参考文献[16,17,18,19]

PTV(cm³)	处方剂量体积与 PTV体积比			50%处方剂量体积与 PTV体积比,R_50%			PTV外2 cm处最大剂量, D_{2 cm}(Gy)			肺20 Gy所占体积百分比, V_{20 Gy}(%)
	偏差			偏差			偏差			偏差
		无		可接受			无	可接受			无	可接受	无	可接受
1.8	<1.2	<1.5	<5.9		<7.5	<50.0		<57.0	<10		<15
3.8	<1.2	<1.5	<5.5		<6.5	<50.0		<57.0	<10		<15
7.4	<1.2	<1.5	<5.1		<6.0	<50.0		<58.0	<10		<15
13.2	<1.2	<1.5	<4.7		<5.8	<50.0		<58.0	<10		<15
22.0	<1.2	<1.5	<4.5		<5.5	<54.0		<63.0	<10		<15
34.0	<1.2	<1.5	<4.3		<5.3	<58.0		<68.0	<10		<15
50.0	<1.2	<1.5	<4.0		<5.0	<62.0		<77.0	<10		<15
70.0	<1.2	<1.5	<3.5		<4.8	<66.0		<86.0	<10		<15
95.0	<1.2	<1.5	<3.3		<4.4	<70.0		<89.0	<10		<15
126.0	<1.2	<1.5	<3.1		<4.0	<73.0		<91.0	<10		<15
163.0	<1.2	<1.5	<2.9		<3.7	<77.0		<94.0	<10		<15

OAR	1 F	3 F	4 F	5 F
脊髓	14 Gy	18 Gy(6 Gy/F)	26 Gy(6.5 Gy/F)	30 Gy(6 Gy/F)
食管	15.4 Gy	27 Gy(9 Gy/F)	30 Gy(7.5 Gy/F)	105%PTV处方剂量
臂丛神经	17.5 Gy	24 Gy(8 Gy/F)	27.2 Gy(6.8 Gy/F)	32 Gy(6.4 Gy/F)
心脏/心包	22 Gy	30 Gy(10 Gy/F)	34 Gy(8.5 Gy/F)	105%PTV处方剂量
大血管	37 Gy	NS	49 Gy(12.25 Gy/F)	105%PTV处方剂量
气管及近端支气管	20.2 Gy	30 Gy(10 Gy/F)	34.8 Gy(8.7 Gy/F)	105%PTV处方剂量
肺	V₇<1 500 cm³	V_10.5<1 500 cm³	V_11.6<1 500 cm³	V_12.5<1 500 cm³
	V_7.4<1 000 cm³	V_11.4<1 000 cm³	V_12.4<1 000 cm³	V_13.5<1 000 cm³
肋骨	30 Gy	30 Gy(10 Gy/F)	40 Gy(10 Gy/F)	NS
皮肤	26 Gy	24 Gy(8 Gy/F)	36 Gy(9 Gy/F)	32 Gy(6.4 Gy/F)
胃	12.4 Gy	NS	27.2 Gy(6.8 Gy/F)	NS
肝脏		17.1 Gy(5.7 Gy/Fx)	19.2 Gy(4.8 Gy/Fx)	21 Gy(4.2 Gy/Fx)

早期非小细胞肺癌立体定向放射治疗指南

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