全脑放疗中保护海马的调强计划设计

发布时间：2018-06-23 13:13

本文选题：全脑放疗 + 海马　；参考：《中国医学物理学杂志》2016年03期

【摘要】：目的:探讨应用直线加速器调强技术实现全脑放疗并对海马保护。方法:选取8例接受全脑放疗+海马保护的乳腺癌脑转移患者,进行全脑临床靶区(CTV)和海马区的勾画,全脑外扩5 mm形成计划靶区(PTV),海马区外扩5 mm形成海马保护区域。利用Varian Eclipse 7.6治疗计划系统设计10野调强计划,处方剂量为3000 c Gy/10F。结果:8例病人的PTV V90平均值为99.5%,V95平均值为98.4%,均匀性指数平均值为0.09。海马平均体积为5.0 cm3,海马保护区域平均体积为26.2 cm3,占全脑体积的1.8%。海马的平均剂量为17.1 Gy,最大剂量为21.7 Gy;海马保护区域的平均剂量为22 Gy,最大剂量为29.3 Gy。海马平均剂量为靶区处方剂量的57%,海马保护区域平均剂量为靶区处方剂量的73%。晶体最大剂量平均值为6 Gy。结论:在全脑放疗中,利用直线加速器调强技术能在保证靶区剂量覆盖和靶区均匀性的情况下降低海马受照剂量,实现神经认知功能的保护。
[Abstract]:Objective: To explore the application of linear accelerator technique to realize whole brain radiotherapy and protection of hippocampus. Method: 8 patients with brain metastases received whole brain radiotherapy plus hippocampal protection were selected, the whole brain clinical target area (CTV) and hippocampus were outlined, the 5 mm formation target area (PTV) of total brain expansion and 5 mm of hippocampus were formed to form the protective region of the hippocampus. The Varian Eclipse 7.6 treatment planning system designed the 10 field intensity program with a prescription dose of 3000 C Gy/10F.: the average value of PTV V90 for 8 patients was 99.5%, the average value of V95 was 98.4%, the average average value of the homogeneity index was 5 cm3, the average volume of the hippocampal protection area was 26.2 cm3, and the average of the 1.8%. hippocampus in the whole brain volume was average. The dose of 17.1 Gy, the maximum dose of 21.7 Gy, the average dose of the hippocampal protection area is 22 Gy, the maximum dose is 29.3 Gy., the average dose of the hippocampus is 57%, the average dose of the target area of the hippocampal protection area is 6 Gy. knots with the maximum dose of the target dose of the 73%. crystal. In the whole brain radiation, the linear accelerator is used to strengthen the intensity. The technology can reduce the dose of hippocampus and protect the neurocognitive function in order to ensure the coverage of target area and the uniformity of target area.
【作者单位】：解放军307医院放疗科;
【分类号】：R730.55;R737.9

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