建立体部伽玛刀治疗肝内肿瘤时获取正常肝脏DVH的方法  

Method establishment of getting normal liver DVH when treating Intrahepatic tumor with whole body gamma ray knife

作　　者：金河天[1] 杨跃新[1] 何文贵[1] 

机构地区：[1]中国人民解放军第202医院放疗中心,辽宁沈阳110003

出　　处：《吉林医学》2012年第25期5416-5417,共2页Jilin Medical Journal

摘　　要：目的:建立OUR WB-GR TYS99治疗肝内肿瘤时获取正常肝脏组织的DVH方法,以其做为评价放射性肝损伤的指标。方法:在做治疗计划时,首先勾画出正常肝组织的轮廓,并设为第2个"肿瘤靶区"(TII),在靶区内给1个1号枪点使70%的等剂量线为0.2 Gy,并与真正的肿瘤靶区(TⅠ)剂量融合。此时,TPS即可给出全肝的容积、平均剂量和DVH。计算相当于常规照射10 Gy(V10)的伽玛刀照射10次的分次剂量,在TPS剂量分布截面图上找到该剂量的等剂量线;在TPS的肝的DVH上即可查到V10占全肝的百分数。结果:给1个极低的剂量到"肝靶区"内与肿瘤靶区剂量融合,肿瘤靶区的剂量分布在融合前和后无改变,而手工数格剂量计算法也证实了TPS给出的各结果参数的合理性。结论:我们创建了新方法,开发了OUR WB-GRTYS99的功能。通过系列的临床观察一定能找到RILD各参数的截点,为更好的预防肝损伤打下坚实的基础。Objective To establish the method of getting normal liver DVH when treating intrabepatic tumor with OUR WB - GR TYS99, and consider it as an index of radioactive damage. Method When making a treatment plan, the procedure was as follows ： Contour the normal liver tissue served as the second tumor target（TII）. Administer a very low dose into the TII with using l#collimator a o. 2GY at 70% isodose line Melt TII with the tumor target region. In result, we conld immediately gain the volume and average of the normal liver tis- sue ,calclrlated the fraction dose of treating 10 fractions by gamma knife which was equal to the 10GY by conventional radiotherapy. On TPS dose distribution film,we found the point of the fraction dose and corresponding was dose line,the volume ratio of the V10 to the whole liver may obtained with the DVH of TPS. Results Administering a very low dose into the＂ liver target region＂ then melting the target region with the tumor target region. The melted dose distribution in the tumor target region was the same as not malted. The method of manual panel count had also proved the results from TPS reasonable. Conclusion We have developed the function of the OURWB - GR TPS99. We will gain the index of RILD through clinic observation establish the method of preventing RILl）.

关 键 词：立体放疗 体部伽玛刀 放射性肝损伤 剂量体积直方图 

分 类 号：R735.7[医药卫生—肿瘤]