吉林大学学报(医学版)

• 基础研究 • 上一篇    下一篇

局部复发鼻咽癌患者再程放疗技术的剂量学参数比较

张 矛,苏清秀,杨金磊,金海国,董 莹,吴 丹,王福香   

  1. 吉林省肿瘤医院放疗三科,吉林 长春 130012
  • 收稿日期:2013-04-02 出版日期:2014-09-28 发布日期:2014-11-24
  • 通讯作者: 王福香(Tel:0431-85877257,E-mail:wfx186865789@qq.com) E-mail:wfx186865789@qq.com
  • 作者简介:张 矛(1962-),男,吉林省长春市人,主任医师,主要从事肿瘤放射治疗学的研究。
  • 基金资助:

     吉林省科技厅自然科学基金资助课题(201015235)

Comparison of dosimetric parameters of re-irradiation in patients with locally recurrent nasopharyngeal carcinoma

ZHANG Mao,SU Qing-xiu,YANG Jin-lei,JIN Hai-guo,DONG Ying,WU Dan,WANG Fu-xiang   

  1. Third Department of Radiation Oncology,Cancer Hospital of Jilin Province,Changchun 130012,China
  • Received:2013-04-02 Online:2014-09-28 Published:2014-11-24

摘要:

目的: 比较容积旋转调强(VMAT)、固定野调强(IMRT)和三维适形(3D-CRT)放疗技术在局部复发鼻咽癌患者治疗中的剂量学参数,分析3种治疗计划的剂量学特性。方法:选择12例局部复发的鼻咽癌患者,采用Pinnacle 9.2和eciseplan 2.03治疗计划系统,每例患者均设计VMAT﹑IMRT和3D-CRT ,比较3组计划的剂量分布及危及器官受量等。结果: MAT及IMRT组适形度指数(CI)相似,但均优于3D-CRT组,组间比较差异有统计学意义(P<0.05)。3组计划的靶区不均匀指数(HI)相近,组间比较差异无统计学意义(P>0.05)。3D-CRT组机器跳数(MU)及出束时间优于其他2组,VMAT组优于IMRT组,组间比较差异均有统计学意义(P<0.05)。危及器官受量,3组计划脑干及晶体受量比较差异无统计学意义(P>0.05);VMAT组和IMRT组脊髓、视神经、视交叉和大脑颞叶的受量明显优于3D-CRT组,组间比较差异有统计学意义(P<0.05),但VMAT组与IMRT组比较差异无统计学意义(P>0.05)。 结论: 3种放疗技术的治疗计划剂量分布有差异,VMAT与IMRT计划均能较好覆盖靶区,并减少周围正常组织受量,满足临床需求。VMAT计划的靶区适形度、MU和出束时间优于IMRT计划。3D-CRT仅在MU和治疗时间上有优势。

关键词: 鼻咽肿瘤, 肿瘤复发, 剂量学参数, 容积旋转调强, 固定野调强, 三维适形放疗

Abstract:

Abstract:Objective To compare the dosimetric parameters of volumetric modulated arc therapy(VMAT),fixed field intensity modulated radiation therapy(IMRT) and three-dimensional conformal radiotherapy(3D-CRT)in the radiotherapy for the patients with locally recurrent nasopharyngeal carcinoma,and to analyze their characteristics.Methods Twelve  patients with locally recurrent nasopharyngeal carcinoma  were treated with VMAT,IMRT and 3D-CRT plan designed by Pinnacle 9.2 and Preciseplan 2.03 treatment planning system.The dosimetric parameters of targeted volumes and organs at risk were compared between three groups.Results The conformation indexes(CI) of VMAT and IMRT plans were similar,and they were both better than 3D-CRT plan,the difference  was significant(P<0.05).The homogeneity index(HI) in three groups were similar,there were no statistically significant differences between them(P>0.05).The monitor units(MU) and beam time in 3D-CRT group were bettethose in other two groups,and VMRT group was better than IMRT group,the statistical differences were observed between three groups(P<0.05).There were no statistical differences of organs at risk such as brainstem and lens between three groups(P>0.05).The doses of the spinal cord,optic nerve,optic chiasm and temporal lobe of brain in VMAT and IMRT groups were better than those in 3D-CRT group,there were statistical differences between them(P<0.05),and the data in VMAT and IMRT groups were similar,and there were no statistical differences(P>0.05).Conclusion There are differences of the targeted dose distribution between the three kinds of radiation technology,while VMAT and IMRT plans  can cover the targeted areas and reduce the received doses of organs at risk.The CI,MU and beam time of VMAT plan are better than those of IMRT plan.3D-CRT plan only has advantage in the MU and beam time.

Key words: nasopharyngeal neoplasms, tumor recurrence, dosimetric parameter, volumetric modulated arc radiotherapy, intensity modulated radiotherapy, 3-dimension

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