摘要
目的:探讨不同宽度多叶准直器(MLC)叶片对食管癌调强放射治疗(IMRT)的剂量学影响,为食管癌IMRT提供更加合理的参考。方法:选取40例食管癌调强病例,采用瓦里安Eclipse13.5治疗计划系统设计放射治疗计划。在MLC的中间区域以及边缘区域进行IMRT优化设计,分别对靶区的基本参数以及危及器官的受量进行比较,分析出两组计划的差异;利用剂量体积直方图比较靶区、肺、心脏和脊髓照射剂量和体积。结果:选择在MLC的中间区域进行优化,靶区的D_(mean)更高,且均匀性以及适形性更优,心脏受量更高,心脏MLC中间区域的D_(mean)和V_(30)值均低于MLC边缘区域,其差异有统计学意义(t=-3.531,t=-3.551;P<0.05);双肺MLC中间区域的D_(mean)、V_5、V_(10)、V_(20)及V_(30)略高于MLC边缘区域,其差异有统计学意义(t=4.773,t=6.282,t=0.047,t=4.536,t=2.075;P<0.05),脊髓剂量MLC中间区域的D_(max)值要高于MLC边缘区域,其差异有统计学意义(t=-5.980,P<0.05)。结论:在肺部、脊髓以及心脏等危及器官都能达到剂量限值的基础上,应尽量选择MLC的中间区域进行优化,使其获得良好的靶区剂量分布,提高肿瘤的控制率。
Objective: To investigate dosimetry effects of vane with different width of multi-leaf collimator (MLC) on intensity modulated radiation therapy (IMRT) of esophageal carcinoma so as to provide more reasonable references for IMRT of esophageal carcinoma. Methods: 40 patients with esophageal carcinoma were selected, and the radiotherapy plan was designed with the Varian Eclipse13.5 treatment plan system. IMRT was optimized in the intermediate and marginal areas of MLC. The basic parameters of target area and the received dose of organs at risk (OAR) were respectively compared, and the differences of them between the two plans were further analyzed. Dose volume histogram was used to compare the dose and volume of radiation in target area, lung, heart and spinal cord. Results: The intermediate area of MLC was chosen to implement optimization, and Dmean of target area was higher, and its homogeneity and conformal were better, and heart injectivity was higher, and both the Dmean and V30 value of intermediate area of MLC were significantly lower those of marginal area of MLC (t=-3.531, t=-3.551, P<0.05). Besides, the Dmean, V5, V10, V20 and V30 of intermediate area of MLC of double lungs were significantly higher than those of marginal area of MLC of double lungs (t=4.773, t=6.282, t=0.047, t=4.536, t=2.075, P<0.05). And the Dmax value of intermediate area of MLC of spinal cord also was significantly higher that of marginal area of MLC of spinal cord (t=-5.980, P<0.05). Conclusion: On the basis that the lungs, the spinal cord, the heart and other OARs can meet the dose limits, the intermediate area of MLC should be chosen to implement optimization as far as possible so as to get a better target dose distribution and increase the control rate of the tumor.
作者
李军
张西志
侯笑笑
张先稳
桂龙刚
陈永东
LI Jun;ZHANG Xi-zhi;HOU Xiao-xiao(Oncology department of the people’s Hospital of Subei, Yangzhou 225001, China)
出处
《中国医学装备》
2019年第5期18-21,共4页
China Medical Equipment
关键词
多叶准直器
食管癌
叶片宽度
调强放射治疗
Multiple leaf collimator (MLC)
Esophageal carcinoma
Leaf width
Intensity module radiation therapy (IMRT)
