摘要
目的探究铅门跟随技术(Jaw Tracking Technique,JTT)和铅门固定技术(Static Jaw Technique,SJT)在宫颈癌调强放疗中剂量学的差异。方法选取25例宫颈癌患者,对每例患者分别在3种治疗模式[动态调强适形放射治疗(Dynamic IntensityModulatedRadiotherapy,dIMRT)、静态IMRT(StaticIMRT,sIMRT)、容积旋转调强放疗(Volumetric Modulated Arc Therapy,VMAT)]下采用两种铅门技术共设计出75组治疗计划,在满足靶区处方总剂量为50Gy下,比较两组治疗计划靶区及危及器官(Organs at Risk,OAR)的剂量分布、机器跳数、出束时间。结果3种治疗技术的治疗计划靶区剂量均能满足临床处方剂量要求,3种治疗模式中JTT计划与SJT计划的计划靶区(Planning Target Volume,PTV)适形度指数和均匀度指数比较,差异均无统计学意义。dIMRT组JTT计划的OAR剂量除膀胱V_(50)其他参数均显著低于SJT计划(P<0.05)。sIMRT组的JTT计划的OAR剂量除小肠V_(50)其他参数均显著低于SJT计划(P<0.05)。VMAT组OAR剂量两种计划比较差异均无统计学意义(P>0.05)。dIMRT组和sIMRT组JTT计划的机器跳数显著高于SJT计划,当剂量率相同时dIMRT组JTT计划的出束时间较SJT计划显著增加(P<0.05),而sIMRT组JTT计划的出束时间显著短于SJT(P<0.05),VMAT组JTT计划和SJT计划的机器跳数比较差异无统计学意义(P>0.05),但JTT计划的出束时间显著高于SJT计划(P<0.05)。结论宫颈癌患者调强放疗中运用JTT和SJT对靶区和OAR受量均能满足临床要求,但dIMRT和sIMRT组JTT能更好地降低OAR受量,减少并发症的发生。VMAT组JTT技术则无明显优势。
Objective To compare the dosimetric difference between jaw tracking technique(JTT)and static jaw technique(SJT)in intensity-modulated radiotherapy for cervical cancer.Methods A total of 25 patients with cervical cancer were selected and treated in three modes:dynamic intensity modulated radiotherapy(dIMRT),static IMRT(sIMRT)and volumetric modulated arc therapy(VMAT)were used to design a total of 75 groups of treatment plans.When the total prescription dose of the target area was 50 Gy.The dose distribution of target volume and organs at risk(OAR),number of monitor units and beam time were compared between the two groups.Results The dose in the target area of the treatment plan of the three treatment techniques could meet the dose requirements of clinical prescription.There was no statistically significant difference in the planning target volume(PTV)conformity index and homogeneity index of the JTT plan and the SJT plan among the three treatment modes.The OAR dose of JTT plan in dIMRT group was significantly lower than that of SJT plan except bladder V_(50)(P<0.05).The OAR dose of JTT plan in sIMRT group was significantly lower than that of SJT plan except small intestinal V_(50)(P<0.05).There was no significant difference in OAR dose between the two plans in VMAT group(P>0.05).The number of monitor units of JTT plan in dIMRT group and sIMRT group was significantly higher than that of SJT plan,and the beam delivery time of JTT plan in dIMRT group was significantly higher than that of SJT plan at the same dose rate(P<0.05),while the beam delivery time of JTT plan in sIMRT group was significantly shorter than that of SJT plan(P<0.05).There was no significant difference in number of monitor units between JTT plan and SJT plan in VMAT group(P>0.05),but the beam time of JTT plan was significantly higher than that of SJT plan(P<0.05).Conclusion The use of JTT and SJT in intensity-modulated radiotherapy for patients with cervical cancer can meet clinical requirements for both target area and the dose of OAR,but the JTT
作者
崔恩萍
王景
裴曦
汪志
CUI Enping;WANG Jing;PEI Xi;WANG Zhi(Department of Radiation Oncology,First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022,China;Center of Radiological Physics,University of Science and Technology of China,Hefei Anhui 230022,China)
出处
《中国医疗设备》
2023年第9期69-74,共6页
China Medical Devices
基金
安徽省自然科学基金(1908085MA27)。
关键词
宫颈癌
容积旋转调强放疗
铅门跟随技术
铅门固定技术
剂量学
cervical cancer
volumetric modulated arc therapy
jaw tracking technique
static jaw technique
dosimetry
