鼻咽癌螺旋断层放射治疗过程中实际受照射剂量的研究

发布时间：2018-03-31 08:32

本文选题：鼻咽癌　切入点：自适应放疗　出处：《中国肿瘤临床》2017年03期

【摘要】：目的:通过螺旋断层放射治疗(tomotherapy)系统的自适应模块,分析鼻咽癌患者靶区和危及器官的剂量在治疗过程中与初始计划的差异,为临床提供帮助。方法:回顾性分析2014年2月至2015年2月昆明医科大学第一附属医院运用tomotherapy系统治疗的10例鼻咽癌患者,通过tomotherapy系统中的自适应模块和Mimvista 6.50软件的计算,将初始计划定义为Plan 1;进行图像引导患者总的实际受照射剂量定义为Plan 2。比较两项计划中肿瘤靶区及危及器官的剂量学差异。结果:Plan 2中计划靶区体积(planning gross target volume,PGTV)的D98、D95的剂量较Plan 1分别下降11.91%、6.88%(P=0.001,P=0.006)。Plan 2中左侧腮腺的Dmean、D50较Plan 1分别增加42.23%、63.82%(P0.001、P=0.001);Plan 2中右侧腮腺的Dmean、D50较Plan 1分别增加38.64%、66.76%(P=0.002,P=0.004)。Plan 2中脊髓的D2剂量较Plan 1也明显增加,增加了16.49%(P=0.026)。结论:鼻咽癌患者在行tomotherapy过程中,非常有必要进一步纠正因解剖结构和摆位所带来的误差,保证放疗计划的精准性。
[Abstract]:Objective: to analyze the difference between the target and organ doses of nasopharyngeal carcinoma patients and the initial plan through the adaptive module of the spiral tomography radiotherapy (SCRT) system. Methods: ten patients with nasopharyngeal carcinoma treated by tomotherapy system in the first affiliated Hospital of Kunming Medical University from February 2014 to February 2015 were analyzed retrospectively by the adaptive module of tomotherapy system and the calculation of Mimvista 6.50 software. The initial plan was defined as Plan 1, and the total actual radiation dose was defined as Plan 2. The dosimetric differences of tumor target area and organ threatening in the two plans were compared. Results the volume of planned target area in the two plans was gross target volume planning gross target volume of PGTV2. The Dmean D50 of the left parotid gland in the left parotid gland of P0.001 decreased by 11.91U 6.88 compared with that of Plan 1, respectively, and the DmeanD50 of the left parotid gland in the left parotid gland was increased by 42.232 + 63.82T ~ (63.82) and 63.82T ~ (0.001), respectively, and the DmeanD50 of the right parotid gland in Plan _ 2 was increased by 38.64% compared with Plan _ 1, respectively, and the D _ 2 dose in the spinal cord in the left parotid gland was significantly higher than that in Plan _ 1, respectively, in the left parotid gland of P0.001, compared with that of Plan _ 1, and the DmeanD50 of the right parotid gland in the right parotid gland was significantly higher than that in Plan _ 1. Conclusion: it is very necessary for nasopharyngeal carcinoma patients to correct the errors caused by anatomical structure and placement in the course of tomotherapy, so as to ensure the accuracy of radiotherapy plan.
【作者单位】：昆明医科大学第一附属医院放疗科;
【基金】：国家自然科学基金项目(编号:81560462) 云南省自然科学基金面上项目(编号:2016FB150) 云南省科技厅“惠民”基金项目(编号:2014RA072)资助~~
【分类号】：R739.63;R730.55

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