摘要
目的:探讨Pinnacle3计划系统中剂量体积(DV)优化联合等效均匀剂量(EUD)优化在结直肠癌调强放疗中的剂量学优势。方法:随机选取结直肠癌患者20例,在Pinnacle3计划系统中设计调强治疗计划,对照组采用DV优化法设计,观察组采用DV与EUD联合优化法设计,比较两组计划中靶区与危及器官的剂量学差异。结果:两组计划均能满足临床要求,观察组肿瘤靶区Dmean和Dmin略有增加,靶区均匀性和适形度好于对照组,差异均有统计学意义(t=-3.36、-2.07、0.10、1.00,P<0.05)。两组计划中,膀胱的V40、V50、Dmean、Dmax,小肠的V30、V50、Dmean、Dmax,左、右股骨头的V30、V40、Dmean、Dmax等剂量参数的差异均有统计学意义(t=-2.61~2.49,P<0.05)。结论:在Pinnacle3计划系统中,对于结直肠癌放射治疗患者,使用DV与EUD联合优化法设计调强放射治疗计划,在保证靶区剂量的同时,可以有效减轻患者膀胱、小肠等危及器官的放射反应。
Objective:To explore the application of dose-volume(DV)combined with equivalent uniform dose(EUD)in the optimization of Pinnacle3 to organs at risk(OARs)in IMRT on colorectal cancer.Methods:We selected 20 patients with colorectal cancer who received IMRT planning in the Pinnacle3 system.The control group were optimized with DV optimization and the combination group were optimized with DV+EUD.The dosimetry difference between the target area and the OARs after two optimization methods was compared.Results:Both of the optimization methods could meet the clinical requirements.The tumor target areas Dmeanand Dminin the combination group increased slightly and the target area uniformity and conformability were also slightly better than those in the control group.The difference between the two groups was statistically significant(t=-3.36,-2.0 7,0.10,1.00,P<0.05).The Dosimetric differences of the bladder in V40,V50,Dmean,Dmax,the small intestine in V30,V50,Dmean,Dmax,and the left and right femoral bones in V30,V40,Dmean,Dmaxbetween the two groups were statistically significantly(all P<0.05).Conclusion:Using DV combined with EUD optimizes the IMRT of colorectal cancer in the Pinnacle3system.We can ensure the dose in the target area while effectively reduce radiation response in the OARs such as bladder and small intestine.
作者
王萍
王继平
谭慷
WANG Ping;WANG Jiping;TAN Kang(Dept.of Oncology,Central Hospital of Huanggang,Huanggang 438000,Hubei,China;Dept.of Radiation and Medical Oncology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第3期423-427,共5页
Medical Journal of Wuhan University
关键词
剂量体积优化
等效均匀剂量优化
调强放疗
结直肠癌
危及器官
Dose-Volume Optimization
Equivalent Uniform Dose Optimization
IMRT
Colorectal Cancer
Organ at Risk
