有无均整器模式下高危神经母细胞瘤容积弧形调强放疗计划的剂量学比较

发布时间：2018-01-16 19:43

本文关键词：有无均整器模式下高危神经母细胞瘤容积弧形调强放疗计划的剂量学比较　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较6 MV X射线非均整模式(FFF)和均整模式(FF)下容积调强弧形放射治疗(Rapid Arc)在高危神经母细胞瘤术后放疗中的剂量学差异,为临床高危神经母细胞瘤术后患者选择最佳放疗技术提供参考。材料和方法:选择高危神经母细胞瘤术后患者10例,行CT模拟定位,并勾画靶区及危及器官。分别对每例患者设计FFF和FF Rapid Arc计划,比较两种计划靶区的最大剂量(Dmax)、平均剂量(Dmean)、靶区适形指数(CI)、均匀性指数(HI)、危及器官的受量、机器跳数和治疗时间。结果:(1)与FF Rapid Arc治疗计划相比,FFF Rapid Arc治疗计划的PTV的Dmax和Dmean均明显增高,差异有统计学意义(P0.05)。FF和FFF Rapid Arc治疗计划的CI分别为0.85±0.03和0.84±0.04(P0.05),HI分别为1.057±0.01和1.062±0.01(P0.05)。(2)FFF Rapid Arc计划显著降低了小肠V10和Dmean(P0.05);FFF Rapid Arc计划显著降低了肾脏V10明显降低(P0.05)。(3)FFF Rapid Arc计划的机器跳数是(474.92±69.37)MU,FF计划的机器跳数是(450.92±61.90)MU。两种计划治疗时间均约2 min,无统计学差异。结论:两种计划均能满足临床治疗需求,FF计划较FFF Rapid Arc计划提供了更好的靶区剂量分布,FFF Rapid Arc计划更利于保护射野边缘危及器官,如肾脏和小肠。虽然FFF Rapid Arc计划的机器跳数高于FF Rapid Arc治疗计划,大分割照射时,FFF模式能明显减少治疗时间,缩短治疗时间,减少治疗中体位移动误差,达到精准治疗。但由于本研究是常规剂量照射,两者的治疗时间无明显差别。
[Abstract]:Objective: to compare the effect of Volumetric intensity modulated arc radiotherapy (VIMRT) on rapid Arc under 6 MV X ray nonuniform mode FFFFFFFFFFFFFFFFFFFFF). Dosimetric differences in postoperative radiotherapy for high-risk neuroblastoma. Materials and methods: 10 patients with high risk neuroblastoma were selected for CT simulation localization. FFF and FF Rapid Arc plans were designed for each patient, and the maximum dose of Dmaxin the two target areas was compared. The mean dose was Dmean, the conformal index of target area was CI, the index of homogeneity was high, and the organ acceptance was endangered. Number of machine jumps and duration of treatment. Results: 1) compared with FF Rapid Arc treatment plan. Both Dmax and Dmean of PTV in FFF Rapid Arc treatment plan were significantly increased. The CI of FFF Rapid Arc was 0.85 卤0.03 and 0.84 卤0.04, respectively. The HI values of 1.057 卤0. 01 and 1. 062 卤0. 01 P0. 05 Rapid Arc significantly decreased the intestinal V10 and Dmean (P < 0. 05). P0.05; The FFF Rapid Arc program significantly reduced kidney V10, significantly reduced the number of machine hops in the P0. 05 Rapid Arc program. 474.92 卤69.37 MU. The number of machine hops in FF plan was 450.92 卤61.90 mu. There was no statistical difference in the time of treatment between the two plans. Conclusion: the two plans can meet the needs of clinical treatment. Compared with the FFF Rapid Arc program, FF program provides better target dose distribution. FFF Rapid Arc program is more helpful to protect the organ at the edge of the field. For example, kidney and small intestine. Although the number of machine hops in the FFF Rapid Arc program is higher than that in the FF Rapid Arc treatment plan, the treatment time can be significantly reduced by using the FFF mode during large segment irradiation. The treatment time was shortened, the position movement error was reduced, and the accurate treatment was achieved. However, there was no significant difference in the treatment time between the two groups because of the conventional dose irradiation in this study.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.4;R730.55

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