宫颈癌术后IMRT和VMAT放疗技术剂量学研究

发布时间：2018-01-17 22:08

  本文关键词：宫颈癌术后IMRT和VMAT放疗技术剂量学研究　出处：《中华肿瘤防治杂志》2017年10期 　论文类型：期刊论文

  更多相关文章： 宫颈癌 放射治疗 IMRT VMAT 剂量学

【摘要】：目的我国是宫颈癌的高发地区,放疗是治疗宫颈癌的主要治疗方式之一。本研究旨在分析宫颈癌术后患者,采用逆向调强放疗技术(intensity modulated radiotherapy,IMRT)和旋转容积调强技术(volumetric modulated arc therapy,VMAT)放疗的剂量学分布特征。方法分析四川省肿瘤医院2014-05-01-2015-10-31接受宫颈癌术后辅助放疗的43例患者临床资料,在同一套CT图像上设计共面七野均分IMRT和共面二弧VMAT计划,处方剂量均为45Gy/25次,危及器官限量参考临床要求,并基于MATLAB平台编程获取计划统计结果,在靶区95%的体积达到处方剂量的条件下,分析比较两种计划的靶区相关参数、危及器官剂量分布、机器跳数和治疗时间等。结果 VMAT技术对危及器官的保护差异较大,小肠V_(30)和V_(20)、膀胱V_(40)、股骨头V_(20)和V_(30)、骨盆V_(20)和V_(30)、马尾D_(max)均优于IMRT计划(P0.05),所有器官的D_(max)和D_(mean)(除直肠偏高外)也均有不同程度的降低,P0.05;VMAT计划体内15Gy左右剂量覆盖的体积较小,15Gy左右剂量覆盖的体积较大,P0.05。两种治疗计划对整个骨盆受照射剂量分布影响最大的是髂骨和髋骨,骶骨的平均剂量D_(mean)均高于髂骨和髋骨,P0.05。VMAT技术放疗的机器平均跳数(558±8)MU和平均治疗时间(2.6±0.3)min明显偏少,平均分别减小了71%和73%,P0.05。结论宫颈癌术后患者采用IMRT和VMAT两种治疗计划,靶区均能获得较满意的剂量分布,但VMAT计划对特定危及器官的保护更好,靶区适形度和均匀度更佳,且放疗机器跳数和治疗时间明显降低。从剂量学角度分析,VMAT技术更具优势。
[Abstract]:Objective China is a high incidence area of cervical cancer, radiotherapy is one of the main treatment methods of cervical cancer. Intensity modulated radiotherapy was used in inverse intensity modulated radiotherapy (IMRT). Volume metric modulated arc therapy. Methods the clinical data of 43 patients receiving adjuvant radiotherapy for cervical cancer from 2014-05-01-2015-10-31 in Sichuan Cancer Hospital were analyzed. The coplanar seven-field mean IMRT and coplanar two-arc VMAT were designed on the same set of CT images. The prescribed dose was 45 Gy / 25 times, which endangered the organ limited reference clinical requirements. And based on the MATLAB platform programming to obtain the statistical results of the plan, under the condition that the volume of target area 95% reaches the prescribed dose, the related parameters of the two plans are analyzed and compared, which endangers the dose distribution of organs. Results there was a great difference in the protection of the endangered organs by VMAT technique, and there was a significant difference between the two groups: Vap30 (small intestine) and 20 cases (Vaps), and Vaps (40) in the bladder (P < 0.05). Both the femoral head and the IMRT are better than the IMRT plan (P0.05) and the Vaphe (V20) and the Vaphe (20) and the Vashi-30 (DX) are better than the IMRT plan (P0.05). In all organs, there was also a decrease of P0.05 in all organs (with the exception of the high rectum). The volume of VMAT plan to cover about 15 Gy dose is larger than that of small dose about 15 Gy. P0.05. the dose distribution of the whole pelvis was most affected by the two treatment plans, the average dose of the sacrum was higher than that of the iliac bone and the hip bone, and the mean dose of the sacrum was higher than that of the iliac bone and the hip bone. P0.05. VMAT technique showed a significant decrease in the mean number of jumps (558 卤8MU) and the average treatment time (2.6 卤0.3min) by 71% and 73%, respectively. P0.05.Conclusion both IMRT and VMAT can obtain satisfactory dose distribution in the target area of patients with cervical cancer after operation, but the VMAT program is better for the protection of specific organs. The conformability and uniformity of the target area are better, and the number of machine hops and the treatment time of radiotherapy are obviously reduced, so it is more advantageous to analyze the technique of VMAT from the dosimetric point of view.
【作者单位】： 四川绵阳四0四医院肿瘤科;四川省肿瘤医院放疗中心;甘肃省肿瘤医院放疗科;
【分类号】：R730.55;R737.33
【正文快照】： 中华肿瘤防治杂志,2017,24(10):708-713Chin J Cancer Prev Treat,2017,24(10):708-713我国宫颈癌发病率居女性恶性肿瘤的首位,早期宫颈癌患者多选择术后辅助放疗,以达到消灭盆腔隐匿病灶,控制局部复发[1-2]。随着放疗技术的发展,逆向调强放疗技术(intensity modulated radiot，

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