摘要
目的分析通量平滑度对肺癌放疗物理计量的影响,为肺癌放疗患者诊疗提供帮助。方法选取2021年8月-2022年12月淄博市市立医院收治的肺癌患者20例,将通量平滑值设置为Smooth4030(即MLC运动及垂直方向40、30)制订肺癌调强的放疗(IMRT)计划。相同优化条件下改变通量平滑度X、Y值,分别为Smooth00、2010、6050、8070、100100,评估计划的剂量学参数。结果Smooth4030通量组的适形度指数(CI)与其他组比较,差异均有统计学意义(P<0.05);除Smooth100100之外,均匀性指数(HI)与其他组比较,差异无统计学意义(P>0.05);Smooth100100通量组危及器官肺V_(5)、V_(20)、V_(30),心脏V_(30)、V_(40)、D_(mean),脊髓D_(max)受量高于Smooth4030通量组,差异均有统计学意义(P<0.05),且在Smooth6050及以上危及器官受量呈现上升趋势。结论通过分析肺癌患者放疗过程中的剂量学参数,Smooth100100通量会使靶区均匀性结果较差,Smooth00通量会影响靶区适形度,故通量平滑度过高或过低效果均不理想,故推荐最佳通量平滑度为Smooth6050。
Objective To analyze the influence of flux smoothness on the physical metrology of lung cancer radiotherapy,and to provide help for the diagnosis and treatment of patients with lung cancer radiotherapy.Methods A total of 20 patients with lung cancer treated in Zibo Municipal Hospital from August 2021 to December 2022 were selected,and the flux smoothing value was set as Smooth4030(namely MLC motion and vertical direction 40,30)to make the intensity modulated radiotherapy(IMRT)plan for lung cancer.Under the same optimization conditions,the flux smoothness X and Y values were changed as Smooth0 O,20 10,60 50,80 70,100 100,respectively,and the dosimetry parameters of the plan were evaluated.Results There were statistically significant differences in the conformal index(CI)between the Smooth4030 flux group and other groups(P<0.05).Except for Smooth100 100,there was no statistically significant difference in the homogeneity index(HI)compared with other groups(P>0.05).The Smooth100 100 flux group had higher levels of organ endangerment,lung V_(5),V_(20),V_(30),heart V_(30),V_(40),D_(mean),and spinal cord D_(max) than the Smooth40 30 flux group,and the differences were statistically significant(P<0.05),and in Smooth60 50 and above,there was an increasing trend in the amount of threatening organ uptake.Conclusion By analyzing the dosimetric parameters during radiotherapy for lung cancer patients,Smooth100 100 flux could lead to poor target homogeneity results,and Smooth0 0flux could affect the target conformance.Therefore,the effect of too high or too low flux smoothness was not ideal.Therefore,the optimal flux smoothness was recommended as Smooth60 50.
作者
曹茂杰
CAO Mao-jie(Department of Radiotherapy,Zibo Municipal Hospital,Zibo Shandong Province 255400,China)
出处
《中国城乡企业卫生》
2024年第3期144-146,共3页
Chinese Journal of Urban and Rural Enterprise Hygiene
关键词
肺癌
放疗
通量平滑度
物理剂量
Lung cancer
Radiotherapy
Flux smoothness
Physical dose
