摘要
目的 比较逆向模拟退火法（IPSA）和等剂量线手动优化法在局部晚期宫颈癌组织间插植治疗中的剂量学差异,为临床提供更佳的计划优化方式。方法 纳入的104例宫颈癌患者均行盆腔体外放疗及5次组织间插植治疗,患者每次BT时均同时采用IPSA和等剂量线手动优化两种计划方式进行剂量优化,配对t检验两种计划方式的剂量学差异。结果 两组间HR-CTV D90、D100以及IR-CTV D90剂量无明显差异,但IPSA组IR-CTV D100为（58.36±2.06） Gy,明显高于等剂量线手动优化组（53.99±2.17） Gy （P=0.025）。OAR方面,IPSA组直肠D2cc为（68.53±2.85） Gy,明显优于手动优化组（71.77±1.79） Gy （P=0.002）;膀胱D2cc手动优化组优于IPSA组,乙状结肠D2cc两者间差异无统计学意义。IPSA组靶区剂量HI及CI均优于等剂量线手动优化组,靶区OI两组差异无统计学意义（P=0.107）。结论 与等剂量线手动优化法相比,IPSA法可提高肿瘤组织的照射剂量,降低直肠D2cc受量,提高靶区CI和HI,是临床上更可取的计划优化方式。
Objective To investigate the dosimetric difference between inverse planning simulated annealing （IPSA） and manual optimized plan for isodose line in interstitial brachytherapy for locally advanced cervical cancer and to provide a better optimization method for clinical application. Methods A total of 104 patients with cervical cancer were enrolled in this study. They received pelvic external beam radiotherapy and interstitial brachytherapy in five fractions. Both IPSA and manual optimized plan for isodose line were used to optimize the dose in each fraction. Dose volume parameters of the two plans were compared to analyze the dosimetric outcome by paired t-test. Resutls There were nosignificant differences in mean D90 and D100 for high-risk clinical target volume （HR-CTV） and D90 for intermediate-risk clinical target volume （IR-CTV） between the two groups （P〉0.05）. The IPSA group had a significantly higher D100 for IR-CTV than the manual optimized group （58.36±2.06 Gy vs. 53.99±2.17 Gy, P=0.025）. For organs at risk, the IPSA group had asignificantly lower mean rectum D2cc and a significantly higher bladder D2cc than the manual optimized group （68.53±2.85 Gy vs. 71.77±1.79 Gy, P=0.002;80.49±3.36 Gy vs. 78.71±2.64 Gy, P=0.034）. There was no significant difference in sigmoid D2cc between the two groups （P〉0.05）. The IPSA group had significantly higher relative dose homogeneity index （HI） and conformity index （CI） of radiation dose for target volume than the manual optimized group （P〈0.05）, and there was nosignificant difference in overdose volume index （OI） between the two groups （P=0.107）. ConclusionsCompared with manual optimized plan for isodose line, IPSA can improve the dose distribution of tumor tissue, reduce mean rectum D2cc, and increase CI and HI, so it is a preferable optimized treatment planning method in clinical application.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2017年第11期1288-1291,共4页
Chinese Journal of Radiation Oncology
基金
吉林省卫生和计划生育委员会项目（20152009）
吉林大学白求恩计划项目（2015411）
关键词
逆向模拟退火法
等剂量线手动优化法
剂量学
宫颈肿瘤/组织间插植
Cervical cancer
Interstitial brachytherapy
Inverse planning simulated annealing
Isodose manual optimized method
Dosimetr
