局部复发鼻咽癌容积弧形调强与适形调强的剂量学对比研究

发布时间：2018-03-16 19:37

本文选题：复发鼻咽癌　切入点：容积弧形调强放疗　出处：《上海交通大学学报(医学版)》2014年03期 　论文类型：期刊论文

【摘要】：目的探讨在局部复发鼻咽癌治疗中容积弧形调强放疗(VMAT)与适形调强放疗(IMRT)的剂量学特点。方法选择30例确诊的局部复发鼻咽癌患者纳入本研究。所有患者均采用同步加量技术给予处方剂量,计划大体肿瘤靶区(PGTV):2.26 Gy/F×30 F,计划临床病灶区(PCTV):2 Gy/F×30 F,每例患者采用相同的剂量学限制条件,分别进行双弧容积弧形调强计划与适形调强计划设计。通过其剂量学分析评估:①靶区覆盖,均匀性及适形性。②危及器官(OAR)剂量分布。③机器跳数。结果 VMAT总体的计划临床靶区平均剂量、2%靶体积受到的剂量(D2)和98%靶体积受到的剂量(D98)高于IMRT(P0.05);计划临床靶区适形性指数(CI)高于IMRT(P0.05);均匀性指数(HI)低于IMRT(P0.05)。VMAT右侧颞叶的D1低于IMRT(P0.05);VMAT脑干的Dmax、D1高于IMRT(P0.05)。VMAT左侧颞颌关节的Dmax、左侧颞叶的Dmax高于IMRT(P0.05);脊髓Dmax、视神经Dmax、晶体Dmax和腮腺D50等OAR的剂量学指标两者比较差异无统计学意义(P0.05)。VMAT比IMRT的总机器跳数平均减少了33.2%(P0.05)。结论对于复发鼻咽癌患者,VMAT的计划临床靶区平均剂量、适形性和均匀性优于IMRT,可以缩短机器跳数。但在正常组织保护方面,VMAT的优势不是特别明显。
[Abstract]:Objective to investigate the dosimetric characteristics of VMATT and IMRTT in the treatment of locally recurrent nasopharyngeal carcinoma. Methods 30 patients with locally recurrent nasopharyngeal carcinoma were included in this study. Simultaneous dosing technique for prescription dose, The gross tumor target was planned to be 2.26 Gy/F 脳 30F, and the clinical focus area was planned to be PCTVV: 2 Gy/F 脳 30F. Each patient was given the same dosimetric restriction. The double arc volume intensity adjustment plan and the conformal intensity adjustment plan were designed, respectively. The dosimetric analysis was used to evaluate the coverage of the target area of 1: 1. Results the average dose of 2% target volume in the planned clinical target area of VMAT was higher than that of the target volume of 98% (D98), and the planned clinical target area was planned to be a clinical target area with a dose of 0. 05% (P 0. 05%). The conformal index (CI) is higher than IMRT P0.05; the homogeneity index (HI) is lower than that of IMRT(P0.05).VMAT in the right temporal lobe (DmaxD1) is lower than that in IMRT P0.05VMAT brain stem is higher than that in left temporomandibular joint of IMRT(P0.05).VMAT, and the Dmax in left temporal lobe is higher than that of IMRT P0.05; the dose of OAR in spinal cord, optic nerve, crystal Dmax and parotid gland D50 is higher than that in left temporal lobe. There was no statistically significant difference between the two indexes. Compared with the total machine jump of IMRT, the average number of VMAT decreased by 33.2 and P0.050.Conclusion the planned average dose of VMAT in patients with recurrent nasopharyngeal carcinoma (NPC) is estimated to be higher than that of the patients with recurrent nasopharyngeal carcinoma (NPC). The conformability and uniformity are superior to IMRTs and can shorten the number of machine hops, but the advantages of VMAT in normal tissue protection are not particularly obvious.
【作者单位】：广西医科大学研究生院;重庆市肿瘤医院放疗科;
【分类号】：R739.63

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