摘要
目的:设计两种不同射野分布的调强放射治疗(IMRT)计划,比较其对中下段食管癌靶区和危及器官(OAR)的剂量差异,为IMRT计划设计提供参考。方法:回顾性的分析2022年11月至2023年5月在商洛市中心医院接受IMRT的17例中下段食管癌患者资料,为每例患者分别设计Plan1、Plan2两组不同射野的IMRT计划,Plan1组射野角度为0°、80°、120°、160°、200°,Plan2组射野角度为30°、130°、180°、230°、330°,计划靶区(PTV)的处方剂量为60 Gy/30次,比较两组计划的剂量参数差异。结果:两组计划靶区剂量参数中2%、98%、50%靶区剂量(D_(2%)、D_(98%)、D_(50%))、均匀性指数(HI)、适形指数(CI)和机器跳数比较,差异均无统计意义(P>0.05);OAR双肺V5、心脏平均剂量(D_(mean))、和脊髓最大剂量(D_(max))差异均无统计学意义(P>0.05);Plan1组双肺接受10、20、30 Gy剂量照射的体积百分比(V_(10)、V_(20)、V_(30))、肺平均剂量(Vmean)分别比Plan2组减少7.44%、21.16%、10.09%、5.31%,差异均有统计学意义(t=-5.845、-7.729、-2.247、-3.960,P<0.05);Plan1组心脏V_(10)、V_(20)分别减少7.23%、5.78%,与Plan2组比较差异均有统计学意义(t=-4.376、-3.523,P<0.01),而V_(30)、V_(40)增加2.7%、4.92%,差异无统计意义(P>0.05);Plan1组与Plan2组心脏Dmean比较差异无统计意义(P>0.05)。结论:两种布野方式都可以满足临床要求,在满足靶区的前提下,Plan1组在OAR保护方面更具优势。
Objective:To design two kinds of intensity modulated radiotherapy(IMRT)plans with different radiation field distributions,and to compare the dose differences of that at the dose of target region and organs at risk(OAR)for middle and lower esophageal cancer,so as to provide a reference for the design of IMRT plan.Methods:The data of 17 patients with middle and lower esophageal cancer who received IMRT at Shangluo Central Hospital from November 2022 to May 2023 were retrospectively analyzed.IMRT plans with different radiation fields for Plan 1 and Plan 2 were designed for each patient.The angles of radiation field for Plan 1 were 0°,80°,120°,160°and 200°,and those for Plan 2 were 30°,130°,180°,230°and 330°,respectively.The prescribed dose to the planning target volume(PTV)was 60 Gy/30 F.The differences in dosimetric parameters between the two plans were compared.Results:There were no statistically significant differences in the dose parameters of 2%,98%,50%target dose(D2%,D98%,D50%),homogeneity index(HI),conformity index(CI)and monitor unit between the two groups(P>0.05).There were no significant differences in V5 of dual lungs,the mean dose(D_(mean))of heart,and the maximum dose(D_(max))of spinal-cord between two groups(P>0.05).The volume percentage(V_(10),V_(20),V_(30))of dual lungs received radiation doses of 10,20 and 30 Gy,and the mean dose(V_(mean))of lung in the Plan1 group reduced respectively 7.44%,21.16%,10.09%and 5.31%than those in the Plan2 group,and the differences of them were statistically significant(t=-5.845,-7.729,-2.247,-3.960,P<0.05).Heart V_(10) and V_(20) in the Plan1 group decreased respectively by 7.23%and 5.78%,with statistical significance(t=-4.376,-3.523,P<0.01),while V_(30) and V_(40) of Plan 1 increased respectively by 2.7%and 4.92%,without statistical significance(P>0.05).There was no significant difference in heart Dmean between the Plan1 group and the Plan2 group(P>0.05).Conclusion:Both two methods of distribution field can meet the clinical requirements,and Plan1 has more advantages in protecting organs at risk under the premise of meeting the requirements of target region.
作者
王浩
丁绮
郭峰
巩延涛
陈根祥
车亚
任英红
杨藴一
李毅
Wang Hao;Ding Qi;Guo Feng;Gong Yantao;Chen Genxiang;Che Ya;Ren Yinghong;Yang Yunyi;Li Yi(The Third Ward Region of Radiation Oncology Department,Shangluo Central Hospital,Shangluo 726000,China;Department of Pharmacy,Shangluo Central Hospital,Shangluo 726000,China;Department of Radiation Oncology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《中国医学装备》
2025年第1期2-6,57,共6页
China Medical Equipment
基金
陕西省自然科学基础研究计划面上项目(2020JM-396)
商洛市科学技术局项目(2022-Y-0044)。
关键词
不同布野方案
中下段食管癌
调强放射治疗(IMRT)计划
剂量学
Different radiation field distribution plans
Middle and lower esophageal cancer:Intensity modulated radiotherapy program
Dosiology
