食管癌螺旋断层放疗及三维适形调强放疗计划剂量学研究

发布时间：2018-03-15 18:31

  本文选题：食管癌　切入点：螺旋断层放疗　出处：《中华肿瘤防治杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的近年来放射治疗设备不断更新,放疗技术持续发展,肿瘤放疗方式有了更多的选择。本研究通过评估食管癌的螺旋断层放疗(tomotherapy,TOMO)及三维适形调强放疗(intensity modulation radiation therapy,IMRT)的剂量学特性,为临床上食管癌放疗方式的选择提供依据。方法选取2014-07-13-2015-02-25浙江省肿瘤医院胸部肿瘤放疗科10例食管癌患者,勾画靶区及正常器官后,分别传输至Raystation及TOMO计划系统,给予肿瘤原发灶(PGTV)61.6Gy/28次,计划靶区(PTV)56.0Gy/28次,根据RTOG 1106标准限制危及器官(organs at risk,OAR)剂量。分别对靶区的剂量体积直方图(dose volume histogram,DVH)、均匀性指数(homogeneity index,HI)、适形性指数(conformal index CI)和OAR(肺、心脏、脊髓)受照最大剂量及平均剂量进行评估。结果两种计划都能满足处方剂量要求和危及器官受量限制。TOMO计划中PGTV的中位均匀性指数(HI)为0.057 5,优于IMRT计划的0.073 5,P=0.047。TOMO计划中PTV的中位适形性指数(CI)为0.785,优于IMRT计划的0.682 5,P=0.009。TOMO计划中PGTV的中位最大剂量Dmax为64.9Gy,明显低于IMRT计划的66.5Gy,P=0.005;TOMO计划中PTV的中位最大剂量Dmax为64.1Gy,明显低于IMRT计划的64.9Gy,P=0.028。TOMO计划的中位总的肺剂量为10.8Gy,低于IMRT计划的11.9Gy,P=0.005。TOMO计划的中位总的心脏剂量为22.6Gy,明显低于IMRT计划的24.3Gy,P=0.028。TOMO计划的中位脊髓最大剂量为40.2Gy,明显低于IMRT计划的41.7Gy,P=0.007。结论食管癌放疗中TOMO放疗计划对比IMRT放疗计划,具有更好的靶区覆盖适形性及剂量分布均匀性,同时明显减少双肺、心脏及脊髓的受照剂量。
[Abstract]:Objective in recent years, radiotherapy equipment has been continuously updated, radiotherapy technology has been continuously developed, tumor radiotherapy methods have been more options. This study evaluated the dosimetric characteristics of modulation radiation therapy for esophageal carcinoma by means of spiral tomography radiotherapy (SCT) and three dimensional conformal intensity modulation radiotherapy (IMRT). Methods Ten patients with esophageal cancer were selected from Department of chest tumor radiotherapy, Zhejiang Provincial Cancer Hospital, 2014-07-13-2015-02-25. After drawing target areas and normal organs, they were transferred to Raystation and TOMO planning system, respectively. The primary tumor was given PGTVV 61.6 Gy / 28 times, and the target area was planned to be 56. 0 Gy / 28 times, according to the RTOG 1106 standard to limit the dose of endangering organs at riskbar. The dose histogram of the target area was dose volume histogram, homogeneity index, conformal index and OARR (lung, heart, heart, etc.) and OARA (lung, heart, heart, etc.) respectively. Results both the maximum dose and average dose of spinal cord irradiation could meet the prescribed dose requirement and the median homogeneity index of PGTV in the Tomo program was 0.057 5, which was better than that of the 0.073 5 Pao 0.047 TOMO in the IMRT program. The median conformance index (CI) of PTV in the stroke is 0.785, which is better than that of the maximum dose of PGTV in the IMRT program 0.6825g P0. 009.TOMO is 64.9 Gy, and significantly lower than that of the IMRT program 66.5 Gyp 0.005 TOMO, the median Dmax of PTV is 64.1 Gy, which is significantly lower than that of the IMRT program 64.9Gy P0. 028.TOMO. The median total lung dose was 10.8Gy, which was significantly lower than that of IMRT's 11.9 Gyp 0.005.TOMO plan (22.6Gy), and significantly lower than that of IMRT's 24.3 Gyp 0.028.TOMO plan's maximum spinal cord dose of 40.2Gy / 0.0070.Conclusion TOMO in esophageal cancer radiotherapy is significantly lower than that of IMRT's plan (41.7 Gyp 0.007Gy). Radiotherapy plan versus IMRT radiotherapy plan, It has better target coverage conformability and dose distribution uniformity, and decreases the radiation dose of both lungs, heart and spinal cord.
【作者单位】： 浙江省肿瘤医院胸部肿瘤放疗科;
【基金】：国家自然科学基金(11547178)
【分类号】：R730.55;R735.1
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