巨块型非小细胞肺癌两种三维适形放疗计划方法的剂量学比较分析  

Comparative Analysis of Metrology of Two Kinds of Three Dimensional Conformal Radiotherapy Plans for Massive Type Non-small-cell Carcinoma

作　　者：滕以娟 纪少春 刘荣强[2] 

机构地区：[1]黑龙江省佳木斯市中心医院放疗科,黑龙江佳木斯154002 [2]福建省南平市第一医院放疗科,福建南平353000

出　　处：《中国医学物理学杂志》2012年第4期3485-3487,共3页Chinese Journal of Medical Physics

基　　金：卫生部WKJ2005-3-006子课题

摘　　要：目的:对巨块型局部晚期非小细胞肺癌制定三维适形放疗计划时,通过改变档块大小优化计划在不增加正常组织受照剂量的同时提高靶区剂量。材料与方法:应用STAR-2000计划系统,对15例巨块型局部晚期非小细胞肺癌分别制定T1、T2模式三维适形放疗计划,T1模式采用以PTV为主设3～4个照射野,档块外扩0 cm～0.2 cm,根据临床处方要求进行优化评估,T2模式是在T1模式3～4个照射野的基础上,PTV档块左右内收-1 cm～-1.5 cm,上下档块不变(0.2 cm)。另加两个照射野,PTV档块左右内收-1.7 cm～-2.5 cm,上下档块不变(0.2 cm),两照射野权重另加总权重的20%。通过体积直方图(DVH)分别统计比较两种模式下的PTV、CTV、GTV危及器官包括脊髓、双肺V20、V30、和心脏的剂量参数。用SPSS13.0软件对两模式计划单因素分析。结果:两模式下的PTV的D95双肺V20、V30、和心脏的各剂量变异均无统计学意义(P>0.05)靶区CTV、GTV的D95剂量差异均有统计学意义(P<0.05)。结论 :T2与T1模式相比,对靶区PTV档块内收进行剂量优化,靶区PTV边缘总剂量及危及器官(肺、脊髓、心脏)总剂量不变,而靶区CTV、GTV总剂量分别增加12%～20%,剂量的提升以期提高靶区的局部控制率。类似于调强放疗的同步加量。Purpose： When working out three dimensional conformal radiotherapy plans for massive type partial advanced non-small-cell carcinoma,the optimizing plan can improve the dose of the target area while increasing the exposure dose of normal tissues continuously through changing the size of the block and the plan.Materials and methods： With the application of the STAR-2000 planning system,we make adiotherapy plans of T1 and T2 modes respectively for 15 cases of part non-small-cell lung cancer.T1 mode applies 3～4 PTV radiation field taking the PTV as the principal thing.The file piece expands 0 cm～0.2 cm,according to clinic prescription to make assessment.T2 mode is based on the file piece of 3～4.PTV shrunken-1 cm～1.5 cm.The top and the down don’t change（0.2 cm）.Radiation fields are added.PTV link stopper shrunken-1.7 cm～2.5 cm on right and left,the top and down not change（0.2 cm）.Two radiation fields weight is added to 20% of gross weight.Through the DVH,dangerous organs of PTV,CTV and GTV are analyzed.The dangerous organs include spinal cord,double lung V20,V30 and heart dose parameters.Use the SPSS13.0 software to analyze the single factor of two model plan.Results： The variation of doses of D96 of PTV,lungs V20,V30 and heart under both modes have no statistics significance（P 〉 0.05）.Conclusions： Comparing T2 and T1 modes,dose optimization is conducted for target area PTV block adduction and the total dose at the target area PTV edge and the total dose at organs at risk（lungs,spinal cord,heart） are kept constant.The target area CTV and GTV total doses respectively increase 12%～20% so as to improve the local control rate of the target area.It is similar to emphasize the synchronous dosage of radiation treatment.

关 键 词：巨块型 肺肿瘤 三维适形放疗计划 剂量学比较 

分 类 号：R730.55[医药卫生—肿瘤]