简化调强放疗技术应用于局部晚期非小细胞肺癌的剂量学研究  

Comparison of dose distribution between simplified IMRT and different curative radiotherapy plans for locally advanced non-small cell lung cancer

作　　者：任骅[1] 张可[1] 王绿化[1] 戴建荣[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2009年第5期357-360,共4页Chinese Journal of Radiation Oncology

摘　　要：目的探讨简化调强放疗技术（sIMRT）在局部晚期非小细胞肺癌（NSCLC）的应用特点，为临床治疗的技术选择提供依据。方法对14例接受同步放化疗的初治的Ⅲ期非小细胞肺癌患者分别设计5个野三维适形放疗（3DCRTsf）、5个野sIMRT（sIMRTsf）、5个野调强放疗（IMRTsf）和7个野调强放疗（IMRTsf）计划，利用剂量体积直方图评价不同照射技术的靶区和正常组织照射剂量、适形指数和不均匀指数。处方剂量为60Gy分30次。同时通过总机器跳数间接比较不同照射技术的治疗时间。结果靶区适形指数以IMRT7f最好，靶区剂量不均匀指数以3DCRT5f最不均匀。所有患者sIMRT计划和IMRT计划均可满足对双肺V20的限定要求，而8例患者3DCRT计划的V20〉30％；所有患者sIMRT计划和IMRT计划均可满足脊髓的限定要求，而5例患者3DCRT计划的脊髓最大剂量〉45Gy；各计划心脏V30和V50均相似，V30均〈40％。机器子野跳数IMRT〉sIMRT〉3DCRT，而IMRT5f与IMRT7f的相当，3DCRT5f、sIMRT5f、IMRT5f和IMRT7f的子野跳数平均值分别为476±23、523±29、764±51和793±44。结论对接受同步放化疗的初治的Ⅲ期非小细胞肺癌患者采用sIMRT计划比3DCRT计划和IMRT计划具最优时效比。Objective To evaluate the dose distribution of target volume and normal tissues with different treatment planning such as three dimensional conformal radiotherapy （3DCRT） , simplified intensi- ty-modulated radiotherapy （slMRT）, and intensity-modulated radiotherapy （IMRT） for patients with locally advanced non-small cell lung carcinoma （NSCLC）. Methods Fourteen patients with stage Ⅲ NSCLC who underwent concurrent radiochemotherapy were enrolled in this study. Five-field 3D-CRT, sIMRT and 5- field or 7-field IMRT plans were performed for each patient. The dose distributions of target volume and normal tissues, conformal index （CI）, and heterogeneous index （HI） were analyzed using the dose-volume histogram for these techniques. The prescription dose was 60 Gy in 30 fractions. The total monitor units （MU） were also analyzed to compare the execution time indirectly. Results The CI for planning target volume （PTV） was superior with IMRT,slMRT to 3DCRT. Conversely, the HI for PTV was 3DCRT 〉 sIMRT 〉 IM- RT. slMRT and IMRT can protect the organs at risk better than 3DCRT. The mean of total MU for 3DCRT5f, sIMRT, IMRT5f and IMRT7f was 476 ± 23,523 ± 29,764 ± 51 and 793 ± 44, respectively. Conclusions Comparing with 3DCRT and IMRT, sIMRT was optimal for clinical practice, sIMRT and IMRT radiotherapy techniques can protect the lung and spinal cord well.

关 键 词：肺肿瘤/放射疗法 放射疗法 三维适形 放射疗法 简化调强 放射疗法 调强 剂量学 

分 类 号：R686[医药卫生—骨科学]