摘要
目的从剂量学角度比较非均整器(FFF)模式下早期非小细胞肺癌(NSCLC)立体定向放射治疗的不同放疗技术。方法选取15例NSCLC作为研究对象,分别设计FFF模式下适形拉弧(CAT)、三维适形技术(3D-CRT)及容积弧形动态旋转调强(VMAT)计划。比较3种计划95%、105%的处方剂量覆盖靶区体积百分数(V95%、V105%)、靶区均匀度(HI)、适形度(CI)、最大剂量(Dmax)和平均剂量(Dmean)、危及器官(OAR)剂量、机器跳数(MU)及治疗时间(TT)。结果 CAT和3D-CRT计划中的计划靶区(PTV)V95%、CI低于VMAT计划(P<0.05),而V105%、HI、Dmax、Dmean高于VMAT计划(P<0.05);在患侧肺V5、V20、V30、V40、Dmean方面,CAT和3D-CRT计划高于VMAT计划(P<0.05);在患侧肺V20、V30方面,3D-CRT计划高于CAT计划(P<0.05);在脊髓Dmax,3D-CRT计划低于CAT与VMAT计划(P<0.05);CAT、3D-CRT计划的MU低于VMAT计划(P<0.05)。在治疗时间上CAT低于3D-CRT,且两者均少于VMAT(P<0.05)。结论 FFF模式下3种计划均能满足临床要求,靶区CI、HI及患侧肺保护的VMAT计划优于CAT和3D-CRT计划,但在执行效率,CAT和3D-CRT更具有优势。
Objective To investigate the dosimetric difference between different radiotherapy techniques in treatment of early stage non small cell lung cancer（NSCLC） using stereotactic body radiotherapy（SBRT） in flattening filter free（FFF） beams. Methods A total of 15 early stage NSCLC patients were recruited in this study; flattening free filter CAT, 3 D-CRT and VMAT plans were generated with the same prescription dose and objective conditions for each patient. Target volume receiving 95% and 105% prescription dose（V95%, V105%）, conformity index（CI）, homogeneity index（HI）, maximum dose（Dmax）, mean dose（Dmean） of target, the radiation dose of organs at risk（OARs）, the monitor units and the treatment time were analyzed among the three types of plan. Results As for PTV, V95%, CI in CAT and 3 D-CRT plans were lower than those in VMAT plan（P 〈 0.05）, while the V105%, HI, Dmax, Dmean were higher than those in VMAT plan（P 〈 0.05）. As for OARS, V5, V20, V30, V40, Dmean of the ipsilateral lung in CAT and 3 D-CRT plans were higher than those in VMAT plan（P 〈 0.05）. V20 and V30 of the ipsilateral lung in 3 D-CRT plan were higher than those in CAT,（P 〈 0.05）. The Dmax of spinal cord in 3 D-CRT was lower than that in CAT and VMAT plans（P 〈 0.05）. MUs of CAT and 3 D-CRT were obviously less than those of VMAT plan（P 〈 0.05）. For the time of treatment, CAT was less than 3 D-CRT, and both of them were less than VMAT（P 〈 0.05）. Conclusion All the three plans with FFF beams meet the clinical requirements, but VMAT performs the best on CI, HI and the protection of ipsilateral lung. But CAT and 3 D-CRT have more advantages as regarding plan execution efficiency.
作者
陈飞
胡静
龚筱钦
党军
游涛
戴春华
Fei Chen;Jing Hu;Xiao-qin Gong;Jun Dang;Tao You;Chun-hua Dai(Department of Radiation Oncology,Afliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212001,China)
出处
《中国现代医学杂志》
CAS
2018年第18期93-97,共5页
China Journal of Modern Medicine
关键词
非均整器模式
剂量学
非小细胞肺癌
立体定向放射治疗
flattening filter-free
dosimetric
non-small cell lung cancer
stereotactic body radiation therapy
