摘要
目的探讨广义等效均匀剂量优化(gEUD)在胸部恶性肿瘤放疗中的应用价值。方法选取自2021年10月—2022年6月在安徽省池州市人民医院肿瘤放疗中心治疗的60例胸部恶性肿瘤患者为研究对象,对每位患者进行常规固定CT扫描定位,分2组在Varian Eclipse 15.6计划系统中采用相同射野方向和相同权重。第1组计划采用常规剂量-体积物理目标函数加Upper gEUD目标函数,并使用Varian Eclipse 15.6计划系统推荐的EUD值对危及器官进行优化;第2组仅采用常规剂量-体积物理目标函数对危及器官进行优化。观察并比较2组危及器官的照射剂量。结果采用常规剂量-体积物理目标函数加Upper gEUD目标函数较仅使用常规剂量-体积物理目标函数在肺V5Gy差异无统计学意义、V20Gy和平均剂量有显著降低;心脏V_(30)Gy、V_(40)Gy和平均剂量有一定降低;脊髓最大剂量有明显降低。结论gEUD目标优化可以有效地保护胸部恶性肿瘤放疗中的正常组织,建议在放疗计划优化中使用gEUD目标函数。
Objective To explore the value of generalized equivalent uniform dose(gEUD)optimization in radiotherapy for chest malignant tumors.Methods Sixty patients with chest malignant tumors who were treated in Center for Tumor Radiotherapy,Chizhou Municipal People’s Hospital,Anhui Province,China from October 2021 to June 2022 were enrolled;each patient underwent tumor localization with a conventional fixed computed tomography scan.The patients were divided into two groups using the same field direction and weight in the Varian Eclipse 15.6 planning system.The first group was planned using the conventional physical dose-volume objective function plus the Upper gEUD objective function,with organs at risks(OARs)optimized with the EUD values suggested by the Varian Eclipse 15.6 planning system.The second group only adopted the conventional physical dose-volume objective function for OARs optimization.The two groups were compared for the radiation doses delivered to the OARs.Results Compared with the conventional physical dose-volume objective function alone,the addition of Upper gEUD objective function resulted in no significant difference in lung V5Gy,but resulted in significant reductions in V20Gy and mean dose in the lungs;some reductions in V_(30)Gy,V_(40)Gy,and mean dose in the heart;and significant reductions in the maximum dose in the spinal cord.Conclusion The gEUD objective optimization can effectively protect the normal tissue in the radiotherapy for chest malignant tumors and thus is recommended in radiotherapy planning.
作者
章枫
查道俊
鲍瑜
ZHANG Feng;ZHA Daojun;BAO Yu(Center for Tumor Radiotherapy,Chizhou Municipal People’s Hospital,Chizhou 247000 China;Department of Oncology,Chizhou Municipal People’s Hospital,Chizhou 247000 China)
出处
《中国辐射卫生》
2023年第3期349-354,359,共7页
Chinese Journal of Radiological Health
关键词
放射治疗
计划优化
等效均匀剂量优化
胸部肿瘤
Radiotherapy
Plan optimization
Equivalent uniform dose optimization
Chest tumor
