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放疗是不能手术或不愿手术的非小细胞肺癌(NSCLC)病人最重要的治疗手段,但常规放疗后五年生存率仍然非常低,从理论上说,如果能提高肿瘤的受照剂量,则可改善肿瘤控制率和生存率,但是,在常规放疗方式下,若提高肿瘤剂量,则意味着正常组织受照剂量也会相应增加,导致放射性肺炎等严重并发症,从而达不到预期效果。当肺癌患者放疗时受到20Gy以上剂量照射的肺体积(V20)<22%时,2a内放射性肺炎发生率为0,当V20达到22%～31%、31%～40%和40%以上时,2a内放射性肺炎发生率分别可达7%、13%、36%[1]。因此,限制正常组织的照射范围和剂量分布并充分保护肺功能的放疗新技术,如立体定向大分割放疗(SBRT)、4D-CT图像和功能图
Radiotherapy is the most important treatment for patients with non-small cell lung cancer (NSCLC) who can not be treated surgically or reluctantly. However, the 5-year survival rate after conventional radiotherapy is still very low. Theoretically, if the dose of the tumor can be increased, Can improve tumor control rate and survival rate. However, under the conventional radiotherapy mode, if the tumor dose is increased, the dose of the normal tissue will also increase correspondingly, resulting in serious complications such as radiation pneumonitis, thereby failing to achieve the expected effect. The incidence of radiation pneumonitis in 2a was 0% when the volume of lungs (V20) irradiated by 20Gy or more of patients with lung cancer was 22% ~ 31%, 31% -40% and 40% The incidence of radiation pneumonitis in 2a can reach 7%, 13% and 36% respectively [1]. Therefore, new techniques for radiotherapy that limit the range and dose distribution of normal tissue and adequately protect the lung function, such as stereotactic fractionated radiosynthesis (SBRT), 4D-CT images and functional maps