腮腺癌术后两种放疗计划的剂量学研究

发布时间：2018-01-08 01:30

  本文关键词：腮腺癌术后两种放疗计划的剂量学研究　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 腮腺癌 放射治疗计划 剂量学

【摘要】：目的:通过比较腮腺癌术后容积弧形调强放疗(VMAT)和调强放射治疗(IMRT)两种放疗技术各自的的优劣,为腮腺癌术后患者临床放射治疗方案选择上提供相应的理论支持,以期选择最优治疗方案。材料和方法:自2013年7月至2017年3月在我院放疗科接受放疗的腮腺癌术后患者中选取10例分别制定VMAT及IMRT两种放疗计划进行比较。具体放疗范围包括:术后瘤床区(GTVtb)、同侧颈部淋巴引流区Ib、II区和III区;以下情况需包括同侧IV区和V区:局部病灶T3和T4;淋巴结阳性;肿瘤病理类型为低分化。放疗剂量为瘤床区(PGTVtb):5936c Gy/212c Gy/28F;预防区(PTV):5040c Gy/180c Gy/28F。通过对比两种放疗技术靶区剂量分布情况及剂量体积直方图(DVH),比较两种放疗技术的靶区适形度指数(CI)、均匀性指数(HI)、D95、D5和平均剂量(Dmean);危及器官(包括颞颌关节、脊髓、内耳、对侧腮腺及脑干)最大剂量(Dmax)和平均剂量(Dmean)。结果:(1)放疗靶区剂量分布情况:VMAT计划的Dmean、D95和D5均低于IMRT计划,三项差异均无统计学意义。(2)CI方面:VMAT和IMRT二者的PGTVtb分别为0.71±0.09和0.57±0.04(P=0.018),P0.05,差异有统计学意义;PTV分别为0.82±0.04和0.72±0.03(P=0.003),P0.05,差异有统计学意义。HI方面:VMAT和IMRT二者的PGTVtb分别为1.06±0.02和1.14±0.05(P=0.017),P0.05,差异有统计学意义;PTV分别为1.15±0.04和1.23±0.04(P=0.028),P0.05,差异有统计学意义。(3)危及器官保护方面:VMAT和IMRT相比,对侧腮腺Dmax、脊髓Dmax、脑干Dmax VMAT明显低于IMRT,其中P0.05,差异有统计学意义;内耳Dmean高于IMRT,其中P0.05,差异有统计学意义;脊髓Dmean、颞颌关节Dmean VMAT均小于IMRT,其中P0.05,该差异无统计学意义;对侧腮腺Dmean、脑干Dmean、内耳Dmax、颞颌关节Dmax均略高于IMRT,其中P0.05,结果不具有统计学意义。(4)治疗时间和机器跳数方面:容积弧形调强治疗技术与调强放疗技术相比,治疗时间和机器跳数都明显减少,差异有统计学意义。结论:VMAT和IMRT均能满足临床剂量学需求,VMAT有更优良的靶区CI和HI;二者均能很好保护危及器官,并且VMAT优于IMRT;在治疗时间及机器跳数方面VMAT明显优于IMRT,缩短治疗时间,使治疗更加精确。
[Abstract]:Objective: through the parotid carcinoma were compared after volumetric arc intensity-modulated radiotherapy (VMAT) and intensity-modulated radiotherapy (IMRT) for two types of radiation technology to their advantages and disadvantages, provide corresponding theoretical support for the selection of clinical treatment options for patients with parotid carcinoma after operation, in order to select the optimal treatment program. Materials and methods: from from July 2013 to March 2017 in patients receiving radiotherapy in radiotherapy department in our hospital after parotid carcinoma were selected from 10 cases were developed VMAT and IMRT two kinds of radiotherapy were compared. The specific scope includes: postoperative radiotherapy of tumor bed area (GTVtb), ipsilateral cervical lymph drainage area Ib, II area and III area; the following conditions should include the ipsilateral IV and V area: T3 and T4 positive lesion; lymph node; tumor pathological type was low differentiation. The radiation dose to the tumor bed area (PGTVtb): 5936c Gy/212c Gy/28F (PTV); prevention area: 5040c Gy/180c Gy/28F. by comparing the two kinds of technology of target dose distribution 鎯呭喌鍙婂墏閲忎綋绉�鐩存柟鍥�(DVH),姣旇緝涓ょ�嶆斁鐤楁姡�

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