多处方剂量融合正向调强治疗计划在6例鼻咽癌放疗中的应用  

A Study of Forward Treatment Planning with Integrated Multi-Prescription Dose for 6 Cases with Nasopharyngeal Carcinoma

作　　者：王勇[1] 应申鹏 梁晓东[1] 陈卫军[1] 贡强君 刘艳梅[1] 倪玲琴 韩建锋[1] 单国平[2] 胡炜[2] 

机构地区：[1]台州市中心医院,浙江台州318000 [2]浙江省台州医院,浙江台州317000

出　　处：《肿瘤学杂志》2011年第4期267-271,共5页Journal of Chinese Oncology

基　　金：浙江省医药卫生科技项目(2008B198)

摘　　要：[目的]研究多处方剂量融合正向调强治疗计划在鼻咽癌放疗中可行性和适用范围。[方法]6例接受调强放疗的鼻咽癌患者,利用Pinnacle6.2适形治疗计划系统,根据剂量分布,调整照射野的方向和处方剂量数,各计划融合后得到优化的正向调强计划。分别与各自在CORVUS6.3计划上优化的逆向治疗计划比较计划肿瘤区(PGTV)和计划临床靶区(PCTV)的剂量分布、危及器官剂量分布和计划临床靶区的适形度。[结果]根据RTOG0225要求,正向计划肿瘤区和危及器官剂量分布符合处方剂量要求,95%PGTV体积的剂量为69.8～70.8Gy,95%PCTV体积的剂量为54.0～55.6Gy,与逆向计划的58.0～60.4Gy比较有显著性差异(P<0.05)。正向调强与逆向调强计划的中位Mu值分别为300和3000,有显著性差异(P<0.05);两者平均治疗时间分别为10min和25min,有显著性差异(P<0.05)。[结论]多处方剂量融合正向调强治疗计划靶区和危及器官剂量分布符合要求,适用于早期鼻咽癌治疗,计划优化和治疗实施时间缩短。[Purpose] To investigate the feasibility and indications of forward treatment planning with integrated multi-prescription dose for patients with nasopharyngeal carcinoma.[Methods] Six cases with nasopharyngeal carcinoma treated with IMRT technique were enrolled.A forward IMRT treatment plan was created for each patient on Pinnacle 6.2 treatment planning system （TPS）,which was optimized by integrating multi-prescription dose plan according dose distribution.Six inverse IMRT plans were created and optimized on CORVUS 6.3 TPS for these 6 patients,dose distribution of planned treatment volume for gross tumor volume （PGTV）,clinical target volume （PCTV） and organ at risk were compared between forward and inverse IMRT plan for each patient.Comparisons on conformity index （CI） of PCTV were made as well.[Results] Based on dose constraint criterion in the RTOG 0225 protocol,the dose distribution of the PTV and the normal critical structures were met the goal.The dose of 95% volume of PGTV and PCTV received was 69.8～70.8Gy and 54.0～55.6Gy,respectively.The median Mu in forward plan and inverse plan was 300 and 3000 respectively,with significant difference（P0.05）.The average period of treatment in forward plan and inverse plan was 10min and 25min respectively,with significant difference（P0.05）.[Conclusions] The dose distribution of PCTV and organ at risk in forward treatment planning with integrated multi-prescription dose can meet the requirements and the dose is feasible for early stage nasopharyngeal carcinoma.It can shorten the planning and treatment period.

关 键 词：鼻咽肿瘤 调强放射治疗 正向计划 逆向计划 

分 类 号：R730.55[医药卫生—肿瘤] R739.63[医药卫生—临床医学]