摘要
目的 比较宫颈癌逆向调强放疗技术(IMRT)和旋转容积调强技术(VMAT)2种放疗计划的PTV及危及器官剂量学参数差异。方法 回顾性选取2019年8月至2022年8月于宣城市人民医院行手术治疗的78例宫颈癌患者,于同一CT图像上设计IMRT、VMAT计划,处方剂量在45 Gy/25次,危及器官限量参考临床,基于平台获取计划结果,在靶区95%体积达到处方剂量下比较2种计划靶区参数、危及器官剂量分布。结果 VMAT计划对危及器官保护具有较大差异,小肠V20、V30,膀胱V40,股骨头V20、V30,骨盆V20、V30,马尾Dmax优于IMRT计划,差异均有统计学意义(P<0.05);除直肠外各器官Dmax、Dmean下降,差异均有统计学意义(P<0.05)。VMAT计划体内超过15 Gy剂量覆盖体积较小,不足15 Gy积累量覆盖体积较大。两种计划髂骨、髋骨的受照射剂量分布最大,骶骨Dmean高于髂骨、髋骨,差异均有统计学意义(P<0.05)。结论 宫颈癌患者放疗过程中,相对于IMRT,VMAT计划能更好保护危及器官,有良好靶区适形、均匀度。
Objective To compare the dosimetric parameters of planning target volume(PTV) and organ-at-risk between intensity-modulated radiotherapy(IMRT) and volumetric modulated arc therapy(VMAT) for cervical cancer. Methods Seventy-eight patients with cervical cancer underwent surgery in Xuancheng People’s Hospital from August 2019 to August 2022 were retrospectively selected. IMRT and VMAT plans were generated using the same CT image set, and were done with uniform prescription, 45 Gy in 25 fractions. The dose for each specific organ-at-risk were kept below clinical constraint. The plan statistical data was obtained based on platform programming. Then comparison was conducted on PTV and dose distribution of organ-at-risk at the volume receiving at least 95% of the prescribed dose. Results Small intestinal V30,V20, Bladder V40, Femoral head V20, V30, Pelvic V20, V30 and Horsetail Dmax of VMAT plan were better than those of IMRT plan, the differences were statistically significant(P<0.05). Dmax and Dmean in all organs except rectum decreased, the differences were statistically significant(P<0.05). In VMAT plan, the dose coverage volume exceeding 15 Gy was small, and the accumulated coverage volume less than 15 Gy was large. The maximum dose distribution was found in ilium and innominatum, and the Dmean of sacrum was higher than that of ilium and innominatum, the differences were statistically significant(P<0.05). Conclusion During radiotherapy of cervical cancer patients, VMAT program can better protect endangered organs than IMRT, and has better target fitness and uniformity.
作者
王玮
梅长文
宫尚明
WANG Wei;Mei Chang-wen;GONG Shang-ming(Department of Radiotherapy,Xuancheng People's Hospital,Xuancheng Anhui 242000,China.)
出处
《临床和实验医学杂志》
2022年第24期2657-2660,共4页
Journal of Clinical and Experimental Medicine
基金
安徽省自然科学基金面上项目(编号:2008085MH299)。
关键词
宫颈癌
逆向调强放疗技术
旋转容积调强技术
危及器官
剂量学参数
Cervical cancer
Intensity-modulated radiotherapy technique
Volumetric modulated arc therapy technique
Organs at risk
Dosimetric parameters
