摘要
目的评价等效均匀剂量（EUD）优化法在前列腺癌调强放疗计划优化中的应用价值。方法随机抽取10例已接受调强放疗的前列腺癌病例，其治疗计划均基于剂量一体积（DV）优化法得到。将直肠、膀胱、小肠的约束条件改为EUD约束，其他优化条件不变。比较新旧治疗计划的剂量学差异并行配对t检验。结果EUD优化比DV优化对靶区的适形度好（1．00±0．04：0．94±0．04，t=3．80，P=0．04），对危及器官降低了直肠D53（24．4±2．7：25．5±2．6，t=一3．82，P=0．004）、D30（34．1±4．3：39．1±2．1，t=一3．80，P=0．004）、Dl。。3（51．4±1．0：51．8±0．9，t=一2．42，P=0．039）和膀胱V10（92．2±6．2：99．4±1．1，t=一4．28，P：0．002）、V20（70．7±5．7：78．7±6．3，t=一3．10，P=0．013），以及小肠V100（62．2±30．2：74．7±30．0，t=一4．18，P=0．002）、V20（34．3±26．3：46．5±30．9，t=一5．46，P=0．000）、V30（17．1±17．0：25．1±22．6，t=一3．52，P=0．007）、V40（10．6±11．5：15．6±16．1，t=一2．64，P=0．030）。结论EUD优化对靶区适形度好，并能有效降低直肠、膀胱及小肠受照剂量。
Objective To evaluate the role of equivalent uniform dose （EUD） in planning optimization of intensity-modulated radiotherapy （IMRT） for prostate cancer. Methods Ten patients with prostate cancer were randomly selected who treated with IMRT. For these patients, the treatment plans were designed with dose-volume objectives. Based on these plans, new plans were designed through replacing the dose-volume objectives with maximum EUD for rectum, bladder and small bowel, while keeping the dose- volume objectives unchanged. Comparison was made between the new plans and the former cones by paired t-test. Results The conformity index of planning target volume was better with EUD optimization compared to dose-volume （ 1. 00 ± 0. 04 ： 0.94 ±0. 04, t = 3.80, P = 0. 04）. The D53, D30 and D1cm3 for rectum was better with EUD optimization compared to dose-volume （24.4 ± 2. 7 ： 25.5 ± 2. 6, t = - 3.82, P = 0. 004, 34.1±4.3：39.1 ±2. 1,t= -3.80,P =0. 004 and 51.4±1.0：51.8 ±0.9,t = -2.42,P =0. 039）, with V10, V20 for bladder and Vl0, V20, V3o, V40 for small bowel also better with EUD optimization （92.2 ±6. 2： 99.4±1.1,t= -4.28,P=0.002;70.7±5.7：78.7±6.3,t= -3.10,P=0.013 and 62.2±30.2： 74.7 ±30. 0,t = -4. 18 ,P =0. 002;34.3 ±26. 3：46.5±30. 9,t = -5.46,P =0. 000;17.1 ± 17. 0：25.1± 22.6,t= -3.52,P= 0.007;10.6±11.5： 15.6±16.1,t= -2.64,P=0.030）. Conclusions The conformity index of planning target volume is better with EUD optimization compared to dose-volume. And the dose to rectum, bladder and small bowel can be reduced through optimization with EUD optimization compared to dose-volume.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2013年第2期143-146,共4页
Chinese Journal of Radiation Oncology
关键词
等效均匀剂量
放疗计划优化
前列腺肿瘤
调强放射疗法
Equivalent uniform dose
Radiotherapy planning optimization
Prostate neoplasms/intensity-modulated radiotherapy
