摘要
目的探讨胸中段食管癌根治性放疗静态调强(sIMRT)和螺旋断层调强(TOMO)两种技术靶区和危及器官的剂量学参数,为临床治疗选择提供参考。方法选取2015年9月至2019年9月本院收治的17例胸中段食管癌患者作为研究对象,均设计sIMRT计划和TOMO计划,分析比较两组计划靶区和危及器官的剂量学参数。结果靶区PGTV和PTV TOMO的D2、HI均明显低于sIMRT,CI明显高于sIMRT(P<0.05);靶区PTV TOMO的D98高于sIMRT(P<0.05)。双肺的低剂量区V5、V10比较,sIMRT低于TOMO(P<0.05);高剂量区V20、V30比较,sIMRT高于TOMO(P<0.05)。心脏高剂量区V20、V25、V30、V40比较,sIMRT均高于TOMO(P<0.05)。脊髓的D2比较,sIMRT显著高于TOMO,差异具有统计学意义(P<0.05)。结论胸中段食管癌根治性放疗sIMRT、TOMO计划均能满足临床治疗要求,但TOMO靶区的适形性和均匀性明显优于sIMRT,在危及器官的保护上,sIMRT双肺及心脏低剂量区V5、V10的保护优于TOMO,但TOMO在高剂量区V20、V30的保护优于sIMRT。两种不同的放疗技术各有其优劣,临床可以根据实际情况和侧重点,选择适合患者自身的放疗技术。
Objective To explore the technology target area and dosimetric parameters of organs at risk of static intensity-modulated radiotherapy(sIMRT) and tomotherapy(TOMO) in radical radiotherapy for middle thoracic esophageal cancer, to provide reference for clinical treatment selection. Methods Sventeen patients with middle thoracic esophageal cancer admitted in our hospital from September 2015 to September 2019 were selected as the study objects. For each patient, both sIMRT and TOMO plans were designed. The target areas and dosimetric parameters of organs at risk of the two plans were analyzed and compared. Results In the target area PGTV and PTV, D2 and HI of TOMO were significantly lower than those of sIMRT, and CI was significantly higher than that of sIMRT(P<0.05);in the target area PTV, the D98 of TOMO was higher than that of sIMRT(P<0.05). In the low dose area of all-lungs, V5 and V10 of sIMRT were lower than those of TOMO(P<0.05);while in the high dose area, V20 and V30 of sIMRT were higher than those of TOMO(P<0.05). In the high dose area of heart, the V20, V25, V30 and V40 of sIMRT were higher than those of TOMO, the differences were statistically significant(P<0.05). The D2 of spinal cord of sIMRT was significantly higher than that of TOMO(P<0.05).Conclusion Both sIMRT and TOMO plans of radical radiotherapy for middle thoracic esophageal cancer can meet the requirements of clinical treatment, but the conformability and uniformity of the target area of TOMO are significantly better than those of sIMRT. On the protection of organs at risk, the V5 and V10 in the low dose area of all-lungs and heart of the sIMRT are better than those of TOMO, but V20 and V30 in the high dose area of the TOMO are better than those of sIMRT.The two different radiotherapy technologies have their own advantages and disadvantages, so they can be used clinically according to the actual situation and focus to choose the appropriate radiotherapy technology for patients.
作者
赵彪
袁美芳
潘香
杨毅
马立双
孙朝细
ZHAO Biao;YUAN Mei-fang;PAN Xiang;YANG Yi;MA Li-shuang;SUN Chao-xi(Radiotherapy Department,Yunnan Cancer Hospital/the Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;Neurosurgery Department,Yunnan Cancer Hospital/the Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China)
出处
《临床医学研究与实践》
2019年第36期39-41,共3页
Clinical Research and Practice
关键词
食管癌
静态调强放疗
螺旋断层调强放疗
剂量学
胸中段食管癌
根治性放射
esophageal cancer
static intensity -modulated radiotherapy
tomotherapy
dosimetry
middle thoracic esophageal cancer
radical radiotherapy
