肺癌静态调强与容积旋转调强放射治疗间比较  

Comparison With Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Lung Cancer

作　　者：张矛[1] 金海国[1] 苏清秀[1] 卜明伟 吴丹[1] 郭萧[1] 张劲[1] 

机构地区：[1]吉林省肿瘤医院放疗三科,吉林长春130012

出　　处：《中国医学物理学杂志》2013年第5期4364-4368,共5页Chinese Journal of Medical Physics

摘　　要：目的:比较肺癌静态调强(IMRT)计划与容积旋转调强(VMAT)计划间的差异,讨论两种计划的优劣,为临床工作者提供参考。方法:选取14例行CT模拟定位的肺癌患者,其中4例为周围型肺癌,10例为中心型肺癌。采用Monaco2.03治疗计划系统,为每例患者制作7野IMRT和单弧VMAT计划,处方剂量全部为PTV:60 Gy/30 f。比较两组计划的靶区剂量学参数、危及器官剂量学参数及加速器跳数(MU)。结果:两套计划对危及器官的保护较好,均达到临床医生的要求。其中,IMRT组正常肺组织及脊髓的受量略低于VMAT组,虽然双肺V20、V30及脊髓受量两组间无显著统计学差异(P>0.05),但双肺低剂量区(V5,V10)两组间有显著统计学差异(P<0.05)。心脏受量则VMAT组较低,组间比较有显著统计学差异(P<0.05)。适形指数(CI)及均匀指数(HI),VMAT组略优于IMRT组,其中CI值组间有显著统计学差异(P<0.05)。IMRT组MU较低,优于VMAT组(P<0.05)。结论:两套计划各有千秋,对于心脏功能正常、肺功能较差的患者,选择IMRT计划为宜,反之选择VMAT计划为宜。对于心、肺功能尚好的患者,建议行VMAT计划进行治疗。Objective： This planning study compared intensity modulated radiation therapy （IMRT） with volumetric modulated arc therapy （VMAT） in the lung cancer for discussing the prons and cons of the two plans, to provide a reference for clinical practitioners. Methods： A computed tomography （CT） scan for planning was acquired for selected 14 patients of lung cancer, including 4 cases of peripheral lung cancer, 10 cases of central lung cancer.Each patients were replanned to 60 Gy in 30 fractions with 7 wild IMRT and semi-arc VMAT using Monaco treatment planning system.We compared of target dose parameters, organ dosimetry parameters and monitor units （MU） between the two groups.Results： The two sets of plans meeting the requirements of the clinicians for the protection of the organs at risk.The dose of normal lung tissue and spinal cord in the IMRT group is slightly lower than the VMAT group,and the lungs V20, V30 and spinal cord were no significantly difference （P 〉 0.05）,but the low-dose region of lungs （V5, Vl0） between the two groups showed significantly difference （P〈0.05）.The dose of heart to the VMAT group showed significantly differences （P 〈0.05） between two groups.To the conformal index （CI） and homogeneity in- dex （HI）, VMAT group was slightly better than the IMRT group,while CI was significantly difference （P 〈0.05） between two groups. IMRT significantly reduced MU,better than VMAT group （P 〈0.05）. Conclusions： The two plans were strengths and weaknesses, to the poor lung function but normal heart function of patients, the IMRT plan was better and vice versa selected the VMAT plan was appropriate. It was recomended VMAT with normal heart and lung function patients.

关 键 词：肺癌 静态调强 容积旋转调强 

分 类 号：R734.2[医药卫生—肿瘤]