鼻咽癌调强放射治疗与CT模拟定位常规设野放疗的口腔剂量学对比研究

发布时间：2018-05-26 16:31

本文选题：鼻咽肿瘤 + 口腔粘膜炎　；参考：《汕头大学》2010年硕士论文

【摘要】： 目的:比较鼻咽癌常规设野方式以及3种不同机架角布置方式的IMRT计划之间口腔剂量的差异,试图找出能降低口腔剂量的治疗计划设计方案。资料和方法:2009年4月至2009年6月在汕头大学医学院肿瘤医院10例初治鼻咽癌患者接受7野全周等分布野IMRT治疗,机架角为0°,50°,100°,150°,210°,250°,310°(Applied组)。在同样的优化参数下,改变机架角成包括180°射野的全周等分方式治疗(30°,80°,130°,180°,230°,280°,330°)的计划(Opposed组),以及一个射线经由后方射入的南半球方式(80°,110°,140°,180°,210°,240°,280°)治疗计划(South组),并以相同的靶区设计出相应的常规设野计划(Routine组),行方差单变量分析组间配对检验(LSD)。结果:常规设野组(Routine组)与其余3个IMRT组(Applied组,Opposed组,South组)之间,在PTVnx的各组剂量参数上均有显著差异(P0.05);3个IMRT组(Applied组,Opposed组,South组)之间,在各组剂量参数上无任何显著性差异。常规设野组与3个IMRT组之间在CI均存在显著性差异(P0.001);3个IMRT组计划之间CI差异无显著性(P值为0.408,0.625及0.732)。常规设野组(Routine组)与其余3个IMRT组(Applied组,Opposed组, South组)在口腔Min Dose及Mean Dose上有显著差异,常规设野组更低;剂量体积百分比的比较中,常规设野组在V30、V35、V40上与IMRT中的各组均有显著差异;在V45上常规设野组与Opposed组及Applied组有显著差异(P0.05),在V55上常规设野组与South组有显著差异;V60上常规设野组与3个IMRT组之间均存在显著性差异;3个IMRT设计之间,Applied组与Opposed组在Min Dose、V30上存在显著性差;Applied组与South组在V35上存在显著性差异;其余各组数据的相互比较中并未出现显著性差异。结论:常规设野计划与IMRT计划之间在PTVnx及口腔剂量上均存在差异,3种IMRT设计方案肿瘤靶区的剂量基本一致。在口腔的剂量分布上常规设野方案较IMRT计划接受高于25Gy的低剂量照射体积更低,接受高于55Gy的高剂量照射体积更高,结合其他文献报道,提示放射性口腔粘膜炎的发生可能与局部高剂量相关。3种IMRT设野方案之间无明显差异。
[Abstract]:Objective: to compare the difference of oral dose between IMRT plan with conventional field setting and three different rack angle arrangement, and try to find out the treatment plan design which can reduce the oral dose. Materials and methods: from April 2009 to June 2009, 10 patients with nasopharyngeal carcinoma were treated with 7 field isobaric IMRT in the tumor Hospital of Shantou University. With the same optimization parameters, To change the angle of the rack to include a full cycle equipartition of 180 掳field for 30 掳/ 80 掳/ 130 掳/ 180 掳/ 180 掳/ 180 掳/ 180 掳/ 230 掳/ 280 掳/ 330 掳) / unplanned group, and a method of 80 掳/ 110 掳/ 140 掳/ 180 掳/ 210 掳/ 210 掳/ 240 掳280 掳/ 2 / 2 for the southern hemisphere from which a ray is fired through the rear, and to design the corresponding conventional field with the same target area The Routine group was tested by paired test of variance univariate analysis (ANOVA). Results: there were significant differences in the dose parameters of PTVnx between the conventional field group (Routine group) and the other three IMRT groups (applied group exposed group South group), but there was no significant difference in the dose parameters of each group between the three IMRT groups and the applied group (South group). There was significant difference in CI between routine field group and three IMRT groups (P 0.001), but no significant difference in CI between three IMRT groups (P = 0.408 0. 625 and 0. 732g / L). There were significant differences in oral Min Dose and Mean Dose between the conventional field group (Routine group) and the other three IMRT groups (South group). There were significant differences between the routine field group and the IMRT group on V30 V35 and V40. There was significant difference between routine field setting group and Opposed group and Applied group on V45, there was significant difference between routine field setting group and South group on V55, and there was significant difference between routine field setting group and three IMRT group on V60, and between applied group and Opposed group among three IMRT designs. There was a significant difference in V35 between the applied group and the South group on the V30 of Min. There was no significant difference between the other groups. Conclusion: there are differences in PTVnx and oral dose between conventional field planning and IMRT plan. The dose of tumor target area in three IMRT design schemes is basically the same. The dose distribution of oral cavity by conventional field setting scheme was lower than that of IMRT plan, which was higher than that of 25Gy, and higher than that of 55Gy. The results suggest that there may be no significant difference between the occurrence of radioactive oral mucositis and local high dose related IMRT wild-setting regimen.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.63

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