摘要
目的1．通过比较腮腺癌术后常规放疗（CRT）、三维适形放疗（3D—CRT）与调强放疗（IMRT5f、IMRT7f）靶区剂量分布的均匀性、适形性和靶区剂量情况，以及各危及器官受照体积、剂量情况，探讨IMRT用于腮腺癌术后治疗的可行性。2．比较腮腺癌术后IMRT，与正向多子野调强放疗（multi—segment radiotherapy,MSRT）靶区剂量分布的均匀性、适形性和靶区剂量情况，以及各危及器官受照体积、剂量情况，同时比较2种调强技术放疗计划时间和实施治疗时间，探讨MSRT用于腮腺癌术后治疗的优势。方法1．选取10例腮腺癌术后患者，在三维治疗计划系统（TPS）适形指数（cI）上分别对每例患者行X＋E、3D．CRT、IMRT5f、IMRT，及MSRT计划设计。2．分析腮腺癌术后患者分别运用CRT、3D．CRT与IMRT5f、IMRT7f苈法的剂量体积直方图（DVH），比较患者的靶区适形度、均匀指数，靶区剂量、靶区覆盖情况及各个危及器官的受照射剂量，评价腮腺癌术后IMRT较3D．CRT的剂量学优势。3．分析腮腺癌术后患者运用IMRT7f，和MSRT两种放疗方法的DVH图，比较两组患者的靶区适形度、均匀指数，靶区剂量、靶区覆盖情况及各个危及器官的受照射剂量，同时比较2种调强技术放疗计划时间和实施治疗时间，评价腮腺癌术后MSRT较IMRT7f治疗的优势。结果1．在靶区覆盖方面，3D．CRT的V9.5％和CI（96．5％和0．76）明显优于二维照射（77．7％和0．49）（P均〈0．05），但劣于IMRT5f（97．1％和0．77）、IMRT7f（99．1％和0，84）和MSRT（99．7％和0．81）（P均〈0．05），同时IMRT7f的v95％和CI（99．1％和0．84）明显优于IMRT5f（97．1％和0．77）（P均〈O．05）。MSRT的CI（0．81）和IMRT7f（0．84）相比差异无统计学意义（P〉0．05）。2．在危及器官保护方面，脑干、脊髓、对侧腮腺、健侧颌下腺的受照剂量，IMRT7f和MSRT（
Objective 1.To compare the homogeneity and conformity of dose distribution in the target, the treatment period of patients and the dose to the organs at risk among conventional radiation therapy （CRT）, three dimensional conformal radiation therapy （3D-CRT） and intensity modulated radiation therapy （IMRT5f, IMRT7f）, and then to evaluate the clinical value of IMRT for postoperative irradiation of parotid cancer. 2.Multi-segment radiotherapy （MSRT） and IMRT7f were compared using dose-volume histogram data. The conformity index （CI） and heterogeneity index （HI） of dose were used to evaluate the dose coverage of the target volume. Dose sparing of brain stem, spinal cord and the contra lateral parotid was also compared. To compare IMRTTf and MSRT, the timing of planning and radiation delivery was recorded. Method 1 .Ten patients with parotid cancer postoperative were selected. Before the treatment, computed tomography scan images were transferred to an IMRT planning system. To design the unilateral field with mixture of 12 MV photon and electron beams （X＋E）, 3D-CRT, IMRTsf, IMRTTf and MSRT plans respectively for each patient. 2.Through the analysis of the dose volume histogram （DVH） by single lesions of the patients, which using two kinds of radiation methods, compared between the two groups were conformal radiotherapy target area conformal degree, uniform index area, target area dose and each endanger organ by irradiation dose, to investigate the dosimetry advantages of this two methods. 3.For a cohort of 10 patients, MSRT and IMRTTf planning were designed. Plans were compared according to DVH analysis in terms of PTV HI and CI as well as OARs dose and volume parameters. To compare IMRTTf and MSRT, the timing of planning and radiation delivery was recorded. Results 1 .Compared to conventional planning, the 3D-CRT, MSRT, IMRT7f and IMRTse plans produced adequate target coverage, and the CI showed 3D-CRT plans （0.76） and IMRTsf （0.77） produced poorer target coverage than MSRT �
出处
《中国血液流变学杂志》
CAS
2015年第2期177-181,225,共6页
Chinese Journal of Hemorheology
