逆向3D-CRT与IMRT计划设计方法在非小细胞肺癌放疗中的剂量学比较  

Dosimetric Comparison of Inverse Three-Dimensional Conformal Radiotherapy and Intensity Modulated Radiotherapy for Non-Ssmall Cell Lung Cancer

作　　者：张富利[1] 许卫东[1] 高军茂[1] 陈建平[1] 王平[1] 郑明民[1] 

机构地区：[1]北京军区总医院放疗科,北京100700

出　　处：《中国医学物理学杂志》2010年第2期1704-1707,1720,共5页Chinese Journal of Medical Physics

摘　　要：目的:分析、比较用于治疗非小细胞肺癌(NSCLC)的逆向三维适形(inverse3D-CRT)和调强适形(intensity modulat-ed radiotherapy,IMRT)计划。方法:随机选择10例NSCLC患者,采用6MV X射线对每例NSCLC进行逆向3D-CRT和3组IMRT的治疗计划设计,处方剂量为60Gy/2Gy/30次。所有计划都使95%靶区体积达到处方剂量要求。并用ADACPinnacle3计划系统提供的卷积/迭加(convolution/superposition)算法对两种放疗计划进行剂量计算,比较靶区及正常肺组织的剂量分布(PTV95/V20比值)以及Dmax-Dmin等指标。结果:3组IMRT放疗计划的PTV95/V20比值分别比逆向3D-CRT增加1.08(P=0.014)、0.72(P=0.089)和0.42(P=0.318)。结论:与3D-CRT放疗技术相比较,IMRT技术在提高靶区适形度的同时降低了正常肺组织的受照体积,可在NSCLC的放疗中推广应用。Objective： To compare inverse three-dimensional conformal radiotherapy （Inv 3D-CRT） and intensity modulated radiotherapy （IMRT） for non-small cell lung cancer. Methods： For a cohort of 10 patients, Inv 3D-CRT and three groups of IMRT plannings were designed for per patient. The prescribed dose was 60 Gy/2 Gy/30f, 95% of the planning target volume received this dose. Dose was computed with a commercially available TPS using convolution/superposition （CS） algorithm. Plans were compared according to the PTV95/V20 ratio （PTV95/V20） and Dmax-Dmin Results： Compared with Inv 3D-CRT, the PTV99/V20 ratio of three groups of IMRT increased by 1.08 （P= 0.014）, 0.72 （P = 0.089） and 0.42 （P = 0.318）, respectively. ConclusiOns： For NSCLC, IMRT can reduce the dose to the lungs compared with inverse 3D-CRT by improving the conformity of the plan and is worth spreading in clinical work.

关 键 词：逆向三维适形放疗 调强适形放疗 非小细胞肺癌 

分 类 号：R851[医药卫生—航空、航天与航海医学]