全脑全脊髓照射技术的改进  

The Improvement For Craniospinal Radiotherapy

作　　者：齐伟华[1] 王军良[1] 周振山[1] 申戈[1] 杨海燕[1] 杨刚[1] 孙慧茹[1] 

机构地区：[1]军事医学科学院附属医院放疗科,北京100071

出　　处：《中国医学物理学杂志》2013年第4期4243-4244,4302,共3页Chinese Journal of Medical Physics

摘　　要：目的:介绍全脑全脊髓放射治疗的一种新技术。方法:患者采用仰卧位,在整体定位板上做颈肩和体膜固定,行CT扫描定位,将图像传输治疗计划系统,进行三维重建。按照全脑全脊髓照射的要求勾画靶区,设计治疗计划,调整剂量分布。治疗前行CBCT扫描,进行在线的体位验证。结果:通过计划系统进行剂量计算,可以直观显示靶区的剂量分布并加以调整,计划照射野衔接处没有明显的剂量冷点和热点出现体位验证结果符合临床要求;通过CBCT在线验证,保证位置准确。结论:全脑全脊髓放射治疗采用了仰卧位热塑膜固定,较传统的俯卧位使患者更舒适,治疗过程中体位容易保持,确保治疗的准确;CT模拟定位方法,较传统的模拟机定位简单易行,且定位精确;用计划系统计算剂量分布并进行调整,使靶区剂量分布均匀,避免照射野衔接处剂量分布出现冷、热点。Objective： To introduce a new method for craniospinal radiotherapy.Methods： The patients were were treated in the supine position on the whole positioning plate and fixed by the neck-shoulder and body thermoplastic mask, and then they were CT scanned. The CT images of patients were transferred to the Treatment Planning System （TPS） for a 3D reconstruction. Drawing target region and making treatment plan. The patients had a CBCT scanning before treatment for verfying the positons on line.Results：We could directly see the dose distribution on the TPS,and adjusted the treatment plan that there were not any ＂hot＂or ＂cold＂ spots and fulfilled the QA criteria.Conclusions： The supine position and thermoplastic mask were more comfortable for craniospinal radiotherapy, The supine position was easy to maintain in the treatment process and ensured the accurate of treatment. Compared with the traditional simulator, CT simulation was more easy and accurate.Using TPS could make the dose distribution more homogeneous and without ＂hot＂or ＂cold＂ spots.

关 键 词：全脑全脊髓 仰卧位 CT定位 

分 类 号：R730.55[医药卫生—肿瘤]