食管癌放射治疗计划的剂量学比较

发布时间：2017-12-30 20:41

本文关键词：食管癌放射治疗计划的剂量学比较　出处：《辐射研究与辐射工艺学报》2016年05期 　论文类型：期刊论文

【摘要】：比较食管癌患者应用螺旋断层(Tomo Helical,TH)、径照断层(Tomo Direct,TD)、容积旋转调强(Volumetric modulated arc therapy,VMAT)和固定野动态调强(Intensity modulated radiation therapy,IMRT)4种放疗计划的剂量学差异。选取18例食管癌患者,利用Pinnacle9.2计划系统设计单弧360°VMAT放疗计划和5野IMRT放疗计划。利用Tomo HDTM2.0.7计划系统设计TH放疗计划和5野TD放疗计划。利用剂量体积直方图(Dose volume histogram,DVH)统计靶区剂量参数、适形性指数(Conformity index,CI)和均匀性指数(Heterogeneity index,HI),肺、心脏、脊髓剂量体积参数,出束时间和治疗跳数。TH计划靶区适形性和靶区均匀性略优于TD计划,VMAT计划靶区适形性和靶区均匀性略优于IMRT计划,且前两种计划明显优于后两种;TH计划和VMAT计划肺V20Gy、V30Gy,心脏V30Gy、V40Gy分别优于TD计划和IMRT计划;但是TD计划肺V5Gy具有其他计划都不具有的优势。TH计划优于TD计划优于VMAT计划优于IMRT计划。但如果考虑性价比,本研究认为对于食管癌VMAT计划是首选;如果考虑放射治疗计划的质量,TH计划是首选;但如果靶区体积比较大,肺的低剂量无法达到临床要求时,可以考虑用TD计划解决这一难题。
[Abstract]:To compare the use of Tomo Helicalthrum and Tomo Directou TD in patients with esophageal carcinoma. Volumetric modulated arc therapy. Vmatt and the fixed field dynamic intensity modulated radiation therapy. Dosimetric difference of IMRT)4 radiotherapy program. 18 patients with esophageal cancer were selected. Single arc 360 掳VMAT radiotherapy plan and 5 field IMRT radiotherapy plan were designed by using Pinnacle9.2 planning system. Tomo was used. Design of th radiotherapy plan and 5 field TD radiotherapy plan by HDTM2.0.7 planning system. Use dose volume histogram (. Dose volume histogram. DVH was used to calculate dose parameters, conformity index (CI) and uniformity index (Heterogenity index). The dose volume parameters of lung, heart and spinal cord, the time out of the bundle and the number of therapeutic hops. Th plan target area conformability and target homogeneity were slightly better than TD plan. The conformability and uniformity of target area in VMAT plan are slightly better than those in IMRT plan, and the former two plans are better than the latter. Th and VMAT schemes were superior to TD and IMRT schemes in lung V20 Gy V30 Gy and heart V30 Gy V40 Gy, respectively. But TD plan V5Gy has advantages that other plans do not have. Th plan is better than TD plan than VMAT plan is superior to IMRT plan. But if the value for money is considered. This study suggests that VMAT program is the first choice for esophageal cancer. If the quality of radiotherapy plan is considered, th plan is the first choice; But if the size of the target area is large and the low dose of lung can not meet the clinical requirements, the TD plan can be used to solve this problem.
【作者单位】：中国科学院上海应用物理研究所嘉定园区;上海大学;中南大学湘雅医学院附属肿瘤医院;中南大学湘雅三医院;
【基金】：国家自然科学基金(No.11175112)资助~~
【分类号】：R730.55;R735.1
【正文快照】： 放射治疗是食管癌的主要治疗手段之一,但是由于病变区与脊髓、肺等重要器官紧邻,所以主要考虑静态调强放射治疗(Intensity modulated radia-tion therapy,IMRT)和容积旋转调强放射治疗(Volumetric modulated arc therapy,VMAT),有关两种计划剂量学比较的研究也颇多[1-3],总体

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