摘要
目的比较通量平滑度对非小细胞肺癌调强放疗(IMRT)剂量学参数的影响,为非小细胞肺癌IMRT计划设计提供参考。方法选择本院确诊的非小细胞肺癌患者25例做回顾性分析,对每位患者先使用默认的通量平滑值Smooth 4030(MLC运动方向为40,MLC垂直方向为30)制定IMRT计划。在相同的优化条件下,改变通量平滑X、Y值分别为Smooth 00、Smooth 2010、Smooth 6050、Smooth 10080、Smooth 150120重新进行计划设计和评估。评估计划的剂量学参数以及机器跳数(MU)。结果Smooth 00、Smooth 2010通量组D_(2)与Smooth 4030通量组比较,差异有统计学意义(P<0.05);不同通量组CI和D_(98)比较,差异有统计学意义(P<0.05);Smooth 00、Smooth 150120通量组D_(mean)比较,差异有统计学意义(P<0.05);Smooth 150120通量组HI与Smooth 4030通量组比较,差异有统计学意义(P<0.05);Smooth 100100通量组危及器官肺V_(5)、V_(20)、V_(30),心脏V_(30)、V40、D_(mean),脊髓Dmax受量均高于Smooth 4030通量组(P<0.05),通量平滑值在Smooth 6050及以上危及器官受量有上升趋势。随着通量平滑值增大,MU减小明显。结论在非小细胞肺癌IMRT放疗中,结合剂量学参数以及MU数,推荐选取Smooth 4030为通量平滑值。
Objective To compare the effect of fluence smoothing on dosimetric parameters of intensity-modulated radiotherapy(IMRT)for non-small cell lung cancer(NSCLC),and to provide reference for the design of IMRT plan for NSCLC.Methods Twenty-five patients with non-small cell lung cancer diagnosed in our hospital were selected for retrospective analysis.The IMRT plan was first formulated for each patient using the default fluence smoothing value Smooth 4030(MLC motion direction was 40,MLC vertical direction was 30).Under the same optimization conditions,the fluence smoothing X and Y values were changed to Smooth 00,Smooth 2010,Smooth 6050,Smooth 10080 and Smooth 150120,respectively,to redesign and evaluate the plan.The dosimetric parameters and monitor unit(MU)of the plan were evaluated.Results There were significant differences in D_(2) between Smooth 00,Smooth 2010 flux groups and Smooth 4030 flux group(P<0.05).There were significant differences in CI and D_(98) between different flux groups(P<0.05).There was significant difference in D_(mean) between Smooth 00 and Smooth 150120 flux groups(P<0.05).There was significant difference in HI between Smooth 150120 flux group and Smooth 4030 flux group(P<0.05).The V_(5),V_(20) and V_(30) of lung,V_(30) and V40 of heart,D_(mean) and spinal cord Dmax in the Smooth 100100 flux group were higher than those in the Smooth 4030 flux group(P<0.05),and the flux smoothing value showed an upward trend in the organs at risk of Smooth 6050 and above.As the flux smoothing value increased,MU decreased significantly.Conclusion In IMRT radiotherapy for non-small cell lung cancer,it is recommended to select Smooth 4030 as the fluence smoothing value in combination with dosimetric parameters and MU number.
作者
王东
刘可
明智
WANG Dong;LIU Ke;MING Zhi(Room of Radiotherapy,Zigong First People's Hospital,Zigong 643000,Sichuan,China)
出处
《医学信息》
2023年第20期161-164,共4页
Journal of Medical Information
