摘要
目的探讨对常规分割模式下胸部肿瘤适形和调强放疗技术进行脊髓生物效应剂量(BED)评估的必要性和可行性。方法选取2016年5月16日至2016年12月31日于唐山市人民医院放化疗科收治的胸部肿瘤患者30例,应用医诺RTIS治疗计划评估模块对所有患者的治疗计划进行评估,并进行物理剂量(PhD)和BED的比较。依据线性二次方程(L-Q模型)计算2.0Gy照射1次和30次时脊髓在不同剂量曲线的PhD和RED。组间比较采用t检验。结果脊髓的RED曲线位于PhD曲线左侧,计划靶体积(PTV)的BED曲线位于PhD曲线右侧。30例患者的治疗计划中,脊髓的最小、最大、平均PhD与BED分别为(80.41±274.75)、(3398.00±1200.95)、(1265.79±762.49)cGy和(74.71±249.34)、(3118.93±1181.96)、(1181.44±742.18)cGy,差异均有统计学意义(t=0.826、6.143、5.234,P<0.05);PTV的最小、最大、平均PhD和BED分别为(3615.51±1566.10)、(5505.26±1731.64)、(4984.33±1615.59)cGy和(3500.97±1576.92)、(5672.93±1791.98)、(5047.63±1646.57)cGy,差异均无统计学意义(t=6.953、-2.164、-1.193,均P>0.05)。随着剂量曲线的下降,PhD和BED也随之降低,而且相应剂量曲线的BED较PhD更低。结论从增强靶区控制和脊髓保护的角度,胸部肿瘤精确常规分割放疗有必要进行脊髓的BED评估。
ObjectiveTo investigate the necessity and feasibility of evaluation for spinal cord biological effect dose (BED) in clinical radiotherapy on thoracic tumors in the model of conformal or intensity modulated technique and conventional fractionation.MethodsFrom 16 May 2016 to 31 December 2016, 30 patients accepting thoracic radiotherapy were selected in the Radio-chemotherapy department of Tangshan City People's Hospital. Radiotherapy plans of these patients were evaluated by the evaluation module of the RTIS treatment plan system, and then the physical dose(PhD) and BED were compared, respectively. After that, the PhD and BED of the spinal cord in different dose curves for 2.0 Gy irradiation 1 and 30 times were calculated by the linear quadratic equation(L-Q model). T test was used for all comparison between groups in statistics.ResultsThe BED curve of the spinal cord was on the left of the PhD curve, and the BED curve of planning target volume(PTV) was on the right of the PhD curve. In the radiotherapy plans of the 30 patients, for the spinal cord, the minimum maximum, average doses of PhD and BED were (80.41±274.75), (3398.00±1200.95), (1265.79±762.49) cGy and (74.71±249.34), (3118.93±1181.96), (1181.44±742.18) cGy, separately, the differences of them were significantly(t=0.826, 6.143, 5.234, all P < 0.05). However, for the PTV of target the minimum, maximum, average doses of PhD and BED were (3615.51±1566.10), (5505.26±1731.64), (4984.33±1615.59) cGy and (3500.97±1576.92), (5672.93±1791.98), (5047.63±1646.57) cGy, all of them were no significances in statistics (t=6.953, -2.164, -1.193, all P>0.05). With the decline of the dose curve, the PhD and BED were reducing, and the BED were lower than the PhD in the curve for corresponding dose.ConclusionsIn the radiotherapy of thoracic tumors, considering potential enhancement of local target control and better spinal cord protection, it is necessary to evaluate the BED of the spinal cord.
作者
刘卫东
刘建平
郭猛
杨海芳
姜斌
徐春雨
Liu Weidong;Liu Jianping;Guo Meng;Yang Haifang;Jiang Bin;Xu Chunyu(Department of Radio-chemotherapy, Tangshan People's Hospital, Tangshan 063001, China;Shenzhen Yino Intelligence Technology Co. Ltd, Shenzhen 518036, China)
出处
《国际放射医学核医学杂志》
2018年第6期518-523,共6页
International Journal of Radiation Medicine and Nuclear Medicine
关键词
胸部肿瘤
放射疗法
调强适形
脊髓
常规分割
生物效应剂量
Thoracic neoplasms
Radiotherapy,intensity-modulated
Spinal cord
Conventional fractionation
Biological effect dose
