摘要
目的比较瓦里安旋转容积调强(瓦里安为RapidArc)与固定野动态调强(dIMRT)2种调强放疗技术,在胸中段食管癌治疗计划中的剂量学差异。方法应用瓦里安Eclipse治疗计划系统,对20例胸中段食管癌患者分别设计RapidArc和dIMRT放射治疗计划。应用剂量体积直方图,比较2种计划中靶区、危及器官的剂量学差异,并比较2种治疗计划的总机器跳数(MU)和治疗时间。结果 2种放疗计划GTV、PTV的Dmax、Dmean、Dmin、V95%、均匀性指数差异,无统计学意义(P>0.05);RapidArc的GTV适形度指数CI更接近于1,差异有统计学意义(P=0.032)。RapidArc计划的双肺V10、V15、V20、Dmean明显低于dIMRT计划,差异有统计学意义(P<0.05);双肺V5、V302种计划比较差异无统计学意义(P>0.05);RapidArc计划,脊髓D01较dIMRT计划略有升高(P<0.05),心脏V40、Dmean也偏高(P<0.05)。结论对于胸中段食管癌,RapidArc治疗计划可以满足临床剂量学要求,能够更有效降低肺的受量,且具有减少总MU、缩短治疗时间的优点,并减轻了治疗中不确定性因素的影响及患者不适感。
Objective To compare the dosimetric difference between RapidArc and fixed gantry angle dynamic IMRT（dIMRT） for middle Esophageal Carcinoma.Methods Treatment planning was designed by using RapidArc and dlMRT techniques for 20 patients with middle esophageal carcinoma.Dose volume histograms were used to compare the dose distribution on target volumes and organs at risks.The number of monitor units and treatment delivery time were also compared.Results There was no significant dosimetric difference between RapidArc and dIMRT about Dmax（GTV、PTV）、Dmean（GTV、PTV）、Dmin（GTV、PTV）、V95%、homogeneity index（HI）、V5 and V30 of lungs.Compared with dIMRT,conformity index by using RapidArc technique was more close to 1.The average values of lung V10,V15,V20,Dmean were significantly larger in dlMRT than those in RapidArc（P0.05）.RapidAre slightly elevated D01 of the spinal cord,V40 and Dmean of the heart（P0.05）.Conclusion RapidArc plans could meet the clinical therapy needs for middle Esophageal Carcinoma radiotherapy.RapidArc could achieve similar target coverage and sparing of Lung at risk,with fewer monitor units and shorter delivery time than dIMRT.Therefore it can reduce influences of uncertain factors in therapy and patient＇s discomfort.
出处
《实用癌症杂志》
2011年第6期630-633,共4页
The Practical Journal of Cancer
关键词
旋转容积调强
固定野动态调强
胸中段食管癌
剂量学
RapidArc
Dynamic intensity modulated radiation therapy
Middle esophageal carcinoma
Dosimetry
