胸上段食管癌静态调强、容积旋转调强与螺旋断层调强治疗计划剂量学比较

发布时间：2018-05-15 23:11

本文选题：食管癌 + 调强放射治疗　；参考：《昆明医科大学》2015年硕士论文

【摘要】：[目的]：比较胸上段食管癌分别利用静态调强(static intensity modulated radiotherapy,sIMRT)、容积旋转调强(volumetric modulated arc therapy,VMAT)和螺旋断层放疗(TomoTherapy)制定治疗计划的剂量学差异。[方法]：选取6例胸上段食管癌病例,分别制定7野sIMRT、单弧VMAT及常规调制强度的TomoTherapy放射治疗计划,比较靶区PTV最大剂量(PTVDmax)、PTV最小剂量(PTVDmin)、PTV平均剂量(PTVDmean)、95%等剂量线所包括的PTV体积百分比(V95)、适型指数(Conformal index,CI)、剂量不均匀性指数(Heterogeneous Index, HI);比较危及器官(organs at risk,OARs)的剂量差异；比较计划治疗时间(treatment time,TT)及机器跳数(monitor units,MU)的差异。[结果]：1.TomoTherapy计划在靶区的V95、CI和HI方面结果最优,sIMRT最差。2.对危及器官的保护TomoTherapy治疗计划要好于sIMRT、VMAT,脊髓最大剂量Dmax明显减小,差异有统计学意义；TomoTherapy计划肺V20、V30低于sIMRT、VMAT,但V5、V10剂量要高,差异无统计学意义。3.出束及治疗时间VMAT低于sIMRT、TomoTherapy,差异有统计学意义。[结论]：食管癌sIMRT、VMAT和TomoTherapy计划在靶区覆盖和危及器官保护上都可以达到临床要求,在靶区的V95、CI和HI上TomoTherapy计划优于VMAT和sIMRT,但在治疗时问和加速器的机器跳数上VMAT较有优势。
[Abstract]:[objective]: to compare the dosimetric differences between static intensity modulated radiotherapymetric (IMRT), volumetric modulated arc (VMATT) and spiral tomography (SCT) for upper thoracic esophageal carcinoma. [methods] six patients with upper thoracic esophageal carcinoma were selected to formulate 7 field sIMRT, single arc VMAT and conventional modulation intensity TomoTherapy radiotherapy plan. The maximum dose of PTV in target area was compared with that in the target area. The mean average dose of PTV was 95% PTV volume percentage, conformal index, Heterogeneous Index, Heterogenous Index, Hip; and the dose difference of organ endangering organs at riskweed OARs was compared. The difference between planned treatment time (TT) and machine hopping monitor (MUU) was compared. [results] 1. Tomotherapy had the worst results for V95 CI and HI in target area. The therapeutic plan of TomoTherapy was better than that of sIMRT. The maximum dose of Dmax in spinal cord was lower than that of sIMRT. The difference was statistically significant, but the dose of V20 V10 was higher than that of sIMRT V30, but the difference was not statistically significant (P < 0. 3). The maximum dose of Dmax in spinal cord was significantly lower than that of sIMRT V30, but the dose of V5 + V10 was higher than that of sIMRT. The VMAT of beam exit and treatment time was lower than that of sIMRT Tomo Therapy.The difference was statistically significant. [conclusion]: both sIMRTT VMAT and TomoTherapy can meet the clinical requirements in target area coverage and organ protection. The TomoTherapy program on V95 CI and HI in the target area is superior to VMAT and sIMRT, but it is superior to VMAT in the number of machine hops of the accelerator during the treatment.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.1

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