摘要
目的分析中下段食管癌放疗中5野调强计划与7野调强计划的差异，寻找布野最佳方案。方法分别为接受调强放射治疗的12例中下段食管癌患者设计5野调强计划与7野调强计划，计划设计中要求95％的计划靶体积达到处方剂量。在每个病例中，分别比较两种计划的剂量体积直方图统计数据、剂量均匀指数、剂量适形指数。结果两种方案中，7野调强计划的靶区剂量适形度较好（t=2．681，P〈0．05）；两种方案的剂量均匀指数、脊髓受照剂量、心脏受照剂量之间的差异无统计学意义；5野调强计划的双肺V5、V10、V15较低（t=-7．938、-12．055和-4．859，P均〈0．05）。结论在中下段食管癌放疗中，与7野调强计划相比，5野调强计划可以减少肺部的低剂量受照体积，同时提供可以接受的计划靶体积适形度，有助于减少肺部辐射损伤的发生概率，改善患者生存质量，值得在临床工作中推广应用。
Objective To analyze the difference between five-field plan and seven-field plan in intensity modulated radiation therapy for patients with mid- and distal-esophageal carcinoma, and to find out the optimal beam arrangement. Methods Five-field plan and seven-field plan were designed for each of 12 patients with mid- and distal-esophageal carcinoma. 95% of planning target volume was required to achieve prescription dose. Dose-volume histograms statistics, dose uniformity, and dose conformity in every patient were compared respectively. Results Superior dose conformity for planning target volume was shown in seven-field plan （t=2.681, P 〈0.05 ）. Difference was not significant between uniformity in seven-field plan and that in five-field plan. Difference was not significant between doses received by organs at risk, such as spinal cord and heart, in seven-field plan and those in five-field plan. V5, V10, V15 of lungs in five-field plan were lower significantly than those in seven-field plan （t=-7.938, -12.055 and -4.859, all P〈0.05）. Conclusions For patients with thoracic esophageal carcinoma treated by intensity modulate radiation therapy, compared with 7-fielded plan, the volume of lungs with lower dose could be reduced on the premise of acceptable planning target volume coverage by the application of five-plan. Therefore, radiation-induced lung injury occurrence probability would be reduced, and the patient＇s quality of life would be improved. Five-field plan would be worth applying in the clinical work.
出处
《国际放射医学核医学杂志》
2012年第2期121-123,F0003,共4页
International Journal of Radiation Medicine and Nuclear Medicine
关键词
食管肿瘤
放射治疗计划
计算机辅助
放射疗法
调强适形
病例对照研究
Esophageal neoplasms
Radiotherapy planning, computer-assisted
Radiation therapy, intensity-modulated
Case-control studies
