非小细胞肺癌三维适形计划和调强计划剂量学比较与分析  

Dosimetric Comparison and Analysis of 3d Conformal Radiotherap y Treatment Plan and Intensity-modulated Radiotherapy Treatment Plan for Non-Small Lung Cancer

作　　者：刘旭红[1,2] 陈晓[1] 赵彪[1] 潘香[1,2] 鄢佳文[1,2] 柏晗[1,2] 

机构地区：[1]云南省肿瘤医院放疗中心,云南昆明650118 [2]昆明医科大学第三附属医院,云南昆明650118

出　　处：《中国医学物理学杂志》2014年第2期4740-4743,4800,共5页Chinese Journal of Medical Physics

摘　　要：目的:通过比较分析非小细胞肺癌(NSCLC)三维适形治疗计划(3DCRT)和调强治疗计划(IMRT),评价不同计划方案在剂量学上的差异性,确定患者选择合适的放射治疗方式。方法:对20例非小细胞肺癌患者分别制定三维适形治疗计划和调强计划,对它们计划的靶区剂量分布和危及器官的保护进行评估。结果:IMRT治疗计划的以下指标优于相应的3DCRT计划:(1)差异均有统计学意义(P<0.05):PTV参数(Dmean、Dmin、Dmax);适形指数(CI);异质性指数(HI);平均肺剂量(MLD)、肺V10-V30及肺正常组织并发症发生率(NTCP);食管Dmean、V55及食管的早晚期正常组织并发症发生概率(NTCP);心脏V40。(2)差异无统计学意义(P>0.05):肺V5;食管V35;心脏的Dmean及NTCP;脊髓的Dmax及NTCP。结论:和三维适形治疗计划相比,调强计划能有效降低危及器官的高剂量区,尤其对靶区形状极不规则的肿瘤有了解决的方案,在保护正常组织器官方面显示出较明显的优势,为靶区剂量提升创造了空间。Objective： Non-smallcelllungcancer （NSCLC）bymeansofcomparisonandanalysisof3dconformalradiotherapy treatment plan （3DCRT） and intensity-modulated radiotherapy treatment plan （IMRT） ,and evaluate the differences of different schemes on the metrology, determine choose the fight means of radiotherapy. Methods： Select 20 no-small lung cancer pa tients, establish 3d conformal radiotherapy treatment plan and intensity-modulated radiotherapy treatment plan respectively, e valuate target volume dose distribute and spare normal tissue of the two plans. Results： The following indicators of IMRT treatment plan is better than that of the corresponding 3DCRT plan ：（1） The difference was statistically significant（P〈 0.05）： in cluding the indices of PTV（Dmean, Dmin, Dmex）; conformity index （CI）; heterogeneity index（HI）; mean tung dose , Vl0-V30 of lung parenchyma and normal tissue complication probability（NTCP） of lung; V55 and mean dose of esophagus, acute and late normal tissue complication probability（NTCP） of esophagns; V40 of heart. （2） The difference was not statistically significant（P〉0.05）： V5 of lung; V35 ofesophagns; mean dose and normal tissue complication probability （NTCP） of heart; max dose and normal tissue complication probability（NTCP） of Spinal cord. Conclusions： Compared with 3d conformal treatment planning, intensity mod ulated plan can effectively reduce endanger the high dose area of organs, especially the target shape and irregular tumor had the solutions, in protecting normal tissues and organs showed a clear advantage, created a space for target dose increase.

关 键 词：非小细胞肺癌 三维适形治疗计划 调强治疗计划 剂量学 

分 类 号：R734.2[医药卫生—肿瘤]