陀螺刀和容积调强治疗肺部小病灶的剂量学比较

发布时间：2018-02-25 20:25

本文关键词： 肺部小病灶剂量学比较容积调强陀螺刀　出处：《安徽医科大学学报》2017年07期 　论文类型：期刊论文

【摘要】：目的分析Co-60陀螺刀和容积调强(VMAT)治疗肺部小病灶剂量学分布特点,比较两种计划在危及器官(OAR)保护和全身低剂量区体积大小的差异。方法对48例肺部小病灶患者(含原发性肺癌及肺转移癌,共56个病灶),分别设计陀螺刀和VMAT计划,采用剂量体积直方图对靶区和OAR剂量学参数进行评估,并比较两种计划的差异。结果陀螺刀计划的计划靶区平均剂量(PTVDmean),计划靶区最高剂量(PTVDmax),均匀指数,全肺V5、V10和平均受量,患侧肺V5、V10、V20、V30和平均受量均显著高于VMAT计划(P0.05),而VMAT计划的靶区适形指数,健侧肺V5、V10和平均受量,脊髓最大受量,心脏和脊髓平均受量均显著高于陀螺刀计划(P0.05)。结论陀螺刀计划和VMAT计划在治疗肺部小病灶时均能达到肿瘤靶区剂量要求和正常组织剂量约束;陀螺刀计划优势是PTVDmean,健侧肺组织受量低;而VMAT计划优势为肿瘤靶区适形度高,全肺及患侧肺V5、V10和平均受量低。
[Abstract]:Objective to analyze the dosimetric distribution of Co-60 gyroscope knife and volume modulated intensity modulation (VIMT) in the treatment of small pulmonary lesions. Methods 48 patients with small pulmonary lesions (including primary lung cancer and metastatic lung cancer) with 56 lesions were selected to design gyroscope knife and VMAT program respectively. Dose volume histogram was used to evaluate the dosimetry parameters of target area and OAR, and the difference between the two plans was compared. Results the average dose of planned target area of gyroscope knife plan was mean, the maximum dose of planned target area was maxum, uniform index, whole lung V5 / V10 and mean dose. The V5 / V10 / V20 / V30 and average uptake of the affected lung were significantly higher than that of the VMAT plan (P 0.05), while the conformal index of the target area of the VMAT program, the V5 / V10 of the normal lung and the mean dose of V20 / V30 were significantly higher than those of the VMAT plan (P < 0. 05). The mean dose of heart and spinal cord was significantly higher than that of gyroscope knife plan P0.05.Conclusion both gyro knife planning and VMAT plan can meet the target dose requirements and normal tissue dose constraints in the treatment of small pulmonary lesions. The advantage of gyroscope planning was that PTV was mean, and that of healthy lung tissue was low, while that of VMAT was high conformability of tumor target area, low V5 V10 and average recipient of whole lung and affected lung.
【作者单位】：安徽医科大学第一附属医院放疗科;安徽医科大学附属省立医院;安徽省肿瘤医院放疗科;
【基金】：中华国际医学交流基金会先声抗肿瘤治疗专项科研基金(编号:Z-2014-06-16355) 安徽省高校省级自然科学研究项目基金(编号:KJ2010B380)
【分类号】：R730.55;R734.2

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