改进全脑全脊髓螺旋断层放射治疗计划的研究  

Craniospinal Irradiation Using Improved Helical Tomotherapy: Evaluation of Clinical Feasibility

作　　者：文婷[1] 李志强[1] 张晋建[1] 黎静[1] 侯友贤[1] 陈静[1] 贾峻嵩[1] 

机构地区：[1]广州军区总医院螺旋断层放疗中心,广东广州510000

出　　处：《中国医学物理学杂志》2012年第6期3737-3741,共5页Chinese Journal of Medical Physics

摘　　要：目的：通过比较限制与无限制一定照射区域的两种全脑全脊髓螺旋断层放疗方案的剂量学差异．评估通过限制一定照射区域以减少低剂量照射范围的临床可行性。方法：选择8例全脑全脊髓患者分别按照限制与无限制一定照射区域两种方案设计治疗计划，分别比较两个方案的计划靶区和危及器官的剂量分布、剂量体积直方图（DVH）的指标和治疗时间，观察限制一定照射区域后低剂量照射范围的变化及对危及器官的影响。结果：限制一定的照射区域后．靶区的覆盖度、均匀性和适形度与无限制照射区域的治疗方案比较无统计学差异；危及器官的累积剂量除了甲状腺高4％，胸骨柄高5％及肠道高11％以外，其余的危及器官的累积剂量平均降低约26％（8％～75％）。但平均治疗时间增加了1．23倍。结论：两种计划方案均能得到较好的剂量分布，而限制了一定照射区域后在可接受治疗时间范围内能减少低剂量照射区域，更好的保护危及器官。Objective： To compare the dosimetric characteristics of helical tomotherapy using region limit （HT（limit））and non-region limit （HT（unlimit）） for craniospinal irradiation （CSI） as well as their comparison in protecting the normal tissues, Evaluating through limit radiation area to reduce low doses radiation range of clinical feasibility. Methods： Eight patients with CSI were enrolled in this study. HT （limit） and HT （unlimit） plans were created for each patient and compared according to dose-volume histogram （DVH） analysis in terms of PTV homogeneity and conformity indices （HI and CI） as well as OARs dose-volume parameters. Additionally, the treatment delivery times of different technologies were compared. Results： Tow kinds of liT plans resulted in better target dose homogeneity and coverage. Compared whit HT（unlimit）, HT（limit） increaced the thyroid gland dose and sternal handle as well as bowel. While HT （limiti） was to the other groups in protecting of normal tissue, but the average delivery times was 1.23 times of HT （unlimit）. Conclusions： Two kinds of treatment plans can provide good dose distribution. The HT（limit） plan can reduce low dose radiational area and protect OARs.

关 键 词：全中枢放疗 螺旋断层放射治疗 低剂量照射区域 危及器官 

分 类 号：R815.6[医药卫生—放射医学]