局限期中高危前列腺癌旋转调强放疗与调强适形放疗的剂量学比较

发布时间：2018-05-24 01:20

本文选题：局限期中高危前列腺癌 + 旋转调强放疗　；参考：《中南大学》2014年硕士论文

【摘要】：目的：分别运用旋转调强放疗技术(IMAT)与常规固定野调强适形放疗技术(IMRT)为局限期中高危前列腺癌患者制定放疗计划,从剂量学的角度和治疗效率的角度比较两种放疗技术的优劣性。方法：选取2011年4月至2013年12月期间在我院治疗的11例局限期中高危前列腺癌患者,在同一计划系统下,对每例患者分别制定旋转调强(IMAT)计划和固定野调强适形(IMRT)计划,运用等剂量分布曲线和剂量体积直方图(DVH图)评价和比较两种计划,剂量学参数包括靶区、危及器官及正常组织的相关剂量参数,此外,再比较两种计划各阶段的总机器跳数(MU)和总治疗时间(T)。结果：在本研究中,两种计划靶区剂量参数的比较：PTV1、PTV2的适形指数(CI)IMAT计划均优于IMRT计划,差异均具有统计学意义(P0.05),均匀性指数(HI)差异没有统计学意义(P0.05)。PTV1、PTV2的Dmax、Dmin、Dmean差异均无统计学意义(P0.05)。两种计划危及器官剂量参数的比较：直肠Dmax、直肠V70IMRT计划优于IMAT计划,差异具有统计学意义(P0.05)。直肠V5o、小肠Dmax、膀胱Dmax、膀胱V50、左侧股骨头Dmax、左侧股骨头V50两种计划结果相似,差异无统计学意义。直肠V40、右侧股骨头Dmax、右侧股骨头V50IMAT计划优于IMRT计划,差异具有统计学意义(P(0.05)。两种计划正常组织剂量参数的比较：V5、V1o、V15差异没有统计学意义(P0.05),V20、V25、V30、V35、V40、 V45、V50IMAT计划均优于IMRT计划,差异均有统计学意义(P0.05)。两种计划每次治疗机器跳数的比较,对于一阶段计划(S1)来说,MUIMRT=1706.57±260.97, MUIMat=749.00±154.94, IMAT计划比IMRT计划平均少957(56%),差异具有统计学意义(P0.05)。对于二阶段计划(S2)来说,MUINRT=1105±197.77, MUIMAT=836.29±166.31,IMAT计划比IMRT计划平均少269(24%),差异具有统计学意义(P0.05)。两种计划总治疗时间的比较：执行IMAT计划一个弧的时间大约需要70-90秒,两个弧大约3分钟,IMRT计划大约需要15分钟。结论：与IMRT计划比较,IMAT计划靶区适形度有所改善,其余靶区覆盖情况无明显差异,危及器官照射剂量相当,正常器官照射剂量明显降低,机器跳数和治疗时间显著减少。
[Abstract]:Objective: to establish a radiotherapy plan for patients with localized high risk prostate cancer by using rotational intensity modulated radiotherapy (IMATT) and conventional field intensity modulated conformal radiotherapy (IMRTT). The advantages and disadvantages of the two radiotherapy techniques were compared in terms of dosimetry and therapeutic efficiency. Methods: 11 patients with localized high risk prostate cancer treated in our hospital from April 2011 to December 2013 were selected. Under the same planning system, each patient was given a rotating intensity modulated IMATT plan and a fixed field intensity conformal IMRT plan. Using isodose distribution curve and dose volume histogram (DVH) to evaluate and compare the two plans, dosimetric parameters include target area, dose parameters that endanger organs and normal tissues, in addition, Then compare the total machine hops of each stage of the two schemes with the total treatment time. Results: in this study, the comparison of dose parameters of the target area between the two plans was made. The conformal index of 1: PTV1 / PTV2 was better than that of IMRT, and the difference was statistically significant (P 0.05). There was no significant difference in DmaxDmint Dmean of PTV1 / PTV2 (P 0.05). The comparison of dose parameters between the two plans: rectal Dmaxand rectal V70IMRT plan was better than IMAT plan, the difference was statistically significant (P 0.05). The planning results of rectum V5o, small intestine Dmax, bladder Dmax, bladder V50, left femoral head Dmaxand left femoral head V50 were similar, but the difference was not statistically significant. Rectum V40, right femoral head Dmaxand right femoral head V50IMAT plan were superior to IMRT plan, the difference was statistically significant (P 0.05). Comparison of the normal tissue dose parameters of the two plans there was no significant difference in the dose parameters between the two plans. There was no significant difference in the dose parameters between the two plans (P 0.05). The V45 / V50 IMAT plan was better than the IMRT plan, and the difference was statistically significant (P 0.05). Comparing the number of machine hops per treatment between the two plans, for one stage plan (S 1), MUIMRTT was 1706.57 卤260.97, MUIMat=749.00 卤154.94, and IMAT plan was 9575656g less than that of IMRT plan, the difference was statistically significant (P 0.05). For the two-stage plan (S2), MUINRTT (1105 卤197.77), MUIMAT=836.29 卤166.31 (IMAT) was 269m / 24 (P 0.05) less than that of IMRT (P 0.05). Comparison of total treatment time between two plans: it takes about 70-90 seconds to execute one arc of the IMAT plan, and about 15 minutes for the two arcs to take about 3 minutes for the IMRT program. Conclusion: compared with the IMRT plan, the conformal degree of the target area of the IMRT plan is improved, the coverage of the other target areas is not significantly different, the irradiation dose of the endangering organs is equal, the irradiation dose of the normal organs is obviously reduced, the number of machine jumps and the treatment time are significantly reduced.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.25

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