摘要
目的比较固定5野调强和旋转容积调强在中上段食管癌放疗中的剂量学差异。方法选取2018年10-12月在我科治疗的中上段食管癌病患20例,用Monaco5.11计划系统分别设计固定5野调强IMRT、单弧VMAT1和双弧VMAT2,在靶区剂量覆盖率都为95%的情况下在剂量体积直方图(DVH)上比较3组计划靶区和危及器官的剂量学差异。结果 VMAT1计划靶区剂量分布均匀性指数(HI)和IMRT计划适形性指数(CI)较其他两种要好(P <0.05),IMRT计划的靶区最大量和平均受量最小。危及器官方面:IMRT计划对降低脊髓最大受量Dmax和心脏平均受量Dmean要优于其他两种;VMAT1计划对双肺的保护最好,VMAT2计划在心脏V30、V40的保护中有优势。机器跳数方面:IMRT计划机器总跳数最少,VMAT1计划次之,VMAT2计划机器总跳数最多。结论对于胸中上段食管癌,5野调强计划具有脊髓最大受量和心脏平均受量低,靶区适形性好,单次机器跳数低等优点,可以满足临床剂量学要求。
Objective To compare the dosimetric differences between fixed 5-field radiation therapy and volumetric modulated arc therapy for middle and upper esophageal carcinoma. Methods 20 cases of middle and upper esophageal carcinoma patients treated in our department from October to December, 2018 were selected as the study objects. We designed5-field IMRT plan,VMAT1 plan and VMAT2 plan for each esophageal carcinoma patients respectively with Monaco5.11 planning system. The dosimetric differences of maximum target area and organ at risk in the three groups were evaluated by dose volume histogram(DVH) in the case which the target area dose coverage is 95%. Results Homogeneity Index(HI)of Single arc VMAT1 plan and Conformity Index(CI) of 5-field IMRT plan was better than the other two(P < 0.05).The maximum and average dose in the target area of 5-field IMRT plan is the minimal. In terms of organs at risk, the 5-field IMRT plan was superior to the other in reducing the maximal dose to the spinal cord and the average dose of the heart Single arc VMAT1 plan had the best protection for lungs, and double arc VMAT2 plan had advantage on the protection of heart V30 and V40. In terms of the number of monitor units, the fixed 5-field intensity control machine has the least monitor units, followed by single-arc VMAT1, and double-arc VMAT2 machine has the most monitor units. Conclusion 5-field IMRT plan could meet the clinical therapy needs for upper and middle Esophageal carcinoma radiotherapy. It has such advantages as lower maximal dose to the spinal cord and the average dose of the heart, better Conformity Index(CI) of target area and fewer monitor units.
作者
石婷婷
韩济华
张艳
张晓晔
朱志坚
洪君
SHI Tingting;HAN Jihua;ZHANG Yan;ZHANG Xiaoye;ZHU Zhijian;HONG Jun(Department of Radiotherapy,The First Affiliated Hospital of Nanjing Medical University,Huai'an First People's Hospital,Huai'an 223300 China)
出处
《中国辐射卫生》
2020年第1期89-92,共4页
Chinese Journal of Radiological Health
关键词
放射治疗
容积旋转调强
食管癌
剂量学
Radiation Therapy
Volumetric Modulated Arc Therapy
Esophageal Cancer
Dosimetry
