中晚期食管癌三维适形放疗与调强放疗剂量学分析

发布时间：2018-04-01 18:24

  本文选题：食管肿瘤　切入点：三维适形放射治疗　出处：《新疆医科大学》2017年硕士论文

【摘要】：目的:比较胸中段食管癌三维适形放疗(3D-CRT)和不同野调强放疗(IMRT)剂量学差异。方法:病例自2015.2-2015.12首次在我院确诊的15例胸中段食管癌患者,在模拟CT下定位,数据传输至Elekta计划系统。对所有患者统一标准勾画靶区,分别制作3D-CRT、IMRT-5野、IMRT-7野、IMRT-9野4种放疗计划,采用单因素方差分析对4种放疗剂量学行对比分析,显著性差异检验水平设为P0.05。结果:3DCRT和IMRT均能满足靶区内95%的等剂量曲线≥95%PTV体积的剂量学要求,3D-CRT计划与所有IMRT靶区剂量学参数比较适形度指数(CI)、高剂量区体积(V105)、平均剂量(Dmean)均有显著性差异(P0.05)。3D-CRT计划与所有IMRT比较双肺V20有显著性差异(P0.05),双肺低剂量区随IMRT放射野数目增加而增大,高剂量区随放射野数目增加而减小。3D-CRT计划与IMRT比较脊髓受照射最大剂量(Dmax)有显著性差异(P0.05),Dmax随IMRT放射野数目的增加而降低;心脏比较无显著性差异(P0.05)。3DCRT与IMRT比较机器跳数、有效治疗时间均有显著性差异(P0.05)。结论:3D-CRT与IMRT均可满足胸中段食管癌放射治疗要求,在靶区适形性和危及器官保护方面IMRT总体比较略有优势,而3D-CRT减少了机器跳数,缩短了单次治疗时间,可在治疗中获益。
[Abstract]:Objective: to compare the dosimetry difference between 3D-CRT and IMRTT for middle thoracic esophageal carcinoma. Methods: 15 patients with middle thoracic esophageal carcinoma diagnosed in our hospital from May 2 to December 2015 were located under simulated CT. The data were transmitted to the Elekta planning system. The 3D-CRTRT IMRT-5 field IMRT-7 field IMRT-9 field four radiotherapy plans were made for all patients. The single factor variance analysis was used to compare the four radiotherapy dosimetry. Results the dosimetric requirements of 95% isodose curve 鈮，

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