局部进展期胃癌术后调强放疗的剂量学研究  

Comparison of desimetric parameters between IMRT and 3D-CRT for postoperative irradiation in locally advanced gastric carcinoma

作　　者：邓清华[1] 李浦[1] 闫风琴[1] 刘鹏[1] 卢珂[1] 汤忠祝[1] 马胜林[1] 朱远[1] 

机构地区：[1]浙江省肿瘤医院腹部放射治疗科,浙江杭州310022

出　　处：《中华肿瘤防治杂志》2011年第9期713-715,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:通过比较局部进展期胃癌术后调强放疗(IMRT)与三维适形放疗(3D-CRT)计划,评价IMRT与3D-CRT靶区与危及器官剂量分布的优劣。方法:对29例D2手术后完全切除的局部进展期胃癌病例同时作IMRT和3D-CRT计划,处方剂量45 Gy,依据DVH和等剂量曲线评价上述两种治疗计划。结果:与3D-CRT相比,IMRT靶区剂量适形性更好,平均剂量更高(均为P<0.001);IMRT靶区剂量均匀性亦更好(P<0.05)。肝脏平均剂量V5、V20均明显降低(分别为P<0.001及P<0.05);左肾平均剂量、V12、V22.5亦显著减低(均为P<0.001);而右肾平均剂量、V12、V22.5及脊髓最高剂量两者相比差异均无统计学意义。结论:局部进展期胃癌术后患者,IMRT比3D-CRT靶区剂量分布更好,同时能使肝脏和左肾得到更好的保护。OBJECTIVE： To compare the radiotherapy plan between intensity modulated radiation therapy （IMRT） and 3-dimensional conformal radiation therapy （3D-CRT）, and evaluate the dose distribution in target volume and organs at risk. METHODS：Twenty-nine patients with locally advanced gastric carcinoma were included in this study. For each patient IMRT plan and 3D-CRT plan were generated. The dose reference point was at isocenter and prescribed to 45 Gy. Dose volume histogram （DVH） and dose distribution curves were used to evaluation the plans according to the prescribed dose and dose con- straints for organs at risk, including liver, left kidney, right kidney and spinal cord. RESULTS.. When compared with conventional 3D-CRT, IMRT had better target dosimetric distribution （P〈 0. 001）, higher mean dose （P〈0. 001） and better conformality （P〈 0.05）. IMRT significantly reduced the mean dose of V5 and V20 to the liver（P〈0. 001 and P〈0.05 respectively） and V12 and V22.5 of left kidney （P（0. 001）, while the reduction in the dose to the right kidney （V12 and V22, 5） and spinal cord was not significant. CONCLUSION： Compared to 3D-CRT, IMRT has certain advantages in target dosimetrie distribution and protection to targets at risk including liver and left kidney.

关 键 词：放射疗法 适形 胃肿瘤/放射疗法 放射治疗剂量 

分 类 号：R735.2[医药卫生—肿瘤]