利用3DCRT技术提升分次量的探讨  

The exploration of improving perfraction dose by 3DCRT

作　　者：崔援朝[1] 郑亚琴[1] 邢晓汾[1] 邢玉荣[1] 张美静[1] 宋雪蕾[1] 

机构地区：[1]山西省肿瘤医院放疗中心,太原030013

出　　处：《肿瘤研究与临床》2005年第2期106-107,112,共3页Cancer Research and Clinic

摘　　要：目的探讨利用3D C R T技术治疗颅外肿瘤时大幅度提高分次量的可能性。方法回顾性分析总结300例颅外肿瘤的治疗计划。其中胸部肿瘤143例,腹部肿瘤157例。计划靶区体积7.0￣1478cm3,多数计划以90%的等剂量线包围PTV,少数以80%的等剂量线包围PTV的95%。以参考点剂量的90%为处方剂量,分次剂量多为5￣10G y,众数剂量为6￣8G y,疗程一般为5￣15d,间隔0￣1d,总剂量视情况给到常规治疗的根治量或姑息量,生物效应则增加10%￣40%。结果所有治疗计划均顺利完成,患者未出现影响生存质量的并发症。结论由于f因子的作用,3D C R T使得较大幅度增加分次量,缩短总疗程,提高放射的生物效应成为可能;对于体积较大的肿瘤在治疗开始时应积极考虑使用3D C R T技术;由于认知水平有限,使用3D C R T技术不宜过分追求精确计划、精确设计、精确治疗;使用3D C R T技术治疗颅外肿瘤时视治疗目的的不同,给予常规放疗2￣3倍的分次量是安全、可靠、有效的。Objective To evaluate the feasibility of increasing the perfraction dose in treatment of neoplasms by 3DCRT (three- dimention confornial radiation therapy). Methods From May 1998 to June 2002, the radiation therapy plans of 300 out- cranial neoplasms patients were analysed retrospectively, including 143 patients with chest neoplasms and 157 patients with abdomen neoplasms. The PTV was 7.0 ~ 1 478 cm3, major PTV was encircled by 90 % isodose curve, minor 95 % PTV were encircled by 80 % isodose curve. Prescription dose was 90 % reference point dose, perfraction dose was 5 ~ 10 Gy, a majority of dose was 6 ~ 8 Gy, period of treatment was 5 ~ 15 days with an interval of 0 ~ 1 day. The general dose was given to radical cure dose or appeasement dose. The biological effect increased 10 % ~ 30 %. Results All treatment plans were accomplished and there were not complication which reduced patients' QOL. Conclusions 1.Owing to the f factor, increasing dose of perfraction, shortening general period of treatment and improving radiative biological effect were possible during the 3DCRT. 2. It was suggested that the larger out- cranial neoplasms should be treated by 3DCRT firstly, but precise plan, precise design and precise treatment can not intensely be pursued because of the limit of knowledge. 3. During the 3DCRT for out- cranial neoplasms, 2 ~ 3 times routine radiation therapy dose was secure, credible and effective according to different purpose.

关 键 词：颅外肿瘤 3DCRT 分次量 

分 类 号：R730.5[医药卫生—肿瘤]