动态调强与容积调强在老年宫颈癌根治性放疗中的剂量学差异

发布时间：2018-10-24 12:10

【摘要】：目的探讨旋转容积调强技术(VMAT)与固定野动态调强技术(IMRT)在老年宫颈癌患者根治性放疗中剂量学及危及器官保护的差异。方法选取该肿瘤放疗中心接受根治性放疗的老年宫颈癌患者11例,采集CT影像信息后通过VARIAN计划系统对同一图像进行VMAT计划和IMRT计划,比较两者靶区剂量分布、照射野正常组织受量、危及器官受量、治疗时间及加速器跳数(MU)差异。结果与IMRT计划相比,VMAT计划中的适形度指数(CI)更接近1,均匀性指数(HI)更小,差异有统计学意义(P0.05)。照射野正常组织低剂量照射中,VMAT计划的V10、V20、V30、V40均低于IMRT计划(均P0.05)。同时VMAT计划中膀胱的Dmean、V30、V40,小肠的Dmean、V20、V30、V40均低于IMRT计划(均P0.05)。而在股骨头及直肠保护方面,VMAT计划无明显优势。MU及治疗时间方面,VMAT计划明显缩短。结论 VMAT和IMRT计划均能达到计划要求,但前者具有更优的靶区剂量学分布,同时能更好地保护膀胱和小肠,从而减少相关放疗副反应。VMAT计划的MU及治疗时间明显缩短,更符合实际临床要求。
[Abstract]:Objective to investigate the difference between rotational volume intensity modulation (VMAT) and fixed field dynamic intensity modulation (IMRT) in dose and organ protection in elderly patients with cervical cancer. Methods Eleven elderly patients with cervical cancer received radical radiotherapy in the center were collected the information of CT images and carried out VMAT plan and IMRT plan through VARIAN planning system, and the dose distribution of the two target areas was compared. The difference of normal tissue acceptance, organ acceptance, treatment time and accelerator hop number (MU) in irradiation field. Results compared with the IMRT plan, the conformability index (CI) of the VMAT plan was closer to 1, and the homogeneity index (HI) was smaller (P0.05). In the low dose irradiation of normal tissue in the irradiation field, the V10 V 20 V 30 V 40 of VMAT plan was lower than that of IMRT plan (P 0.05). At the same time, the Dmean,V20,V30,V40 of Dmean,V30,V40, small intestine of bladder in VMAT plan was lower than that of IMRT plan (P0.05). However, in the protection of femoral head and rectum, VMAT plan had no obvious advantage, but MU and treatment time, VMAT plan was shortened obviously. Conclusion both VMAT and IMRT can meet the planning requirements, but the former has better dosimetry distribution in target area and can protect bladder and small intestine better, thus reducing the side effects of radiotherapy. The MU and treatment time of VMAT program are shortened obviously. More in line with the actual clinical requirements.
【作者单位】：吉林大学第二医院肿瘤中心放疗科;
【分类号】：R737.33

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