直肠癌术后调强放疗和适形放疗靶区剂量学研究及危及器官毒性观察  

Dosimetric and toxicity study of intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy for postoperative rectal cancer

作　　者：孙彩萍[1] 王建芳[1] 叶万立[1] 陈遐林[1] 朱晓灵[1] 刘秋霞[1] 

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)放疗科,浙江绍兴312000

出　　处：《中国现代医学杂志》2014年第1期54-57,共4页China Journal of Modern Medicine

基　　金：绍兴市科技局科学基金(No:2010A33010)

摘　　要：目的探讨直肠癌术后调强放疗和适形放疗靶区剂量学特点及器官毒性。方法选取在该院肿瘤放疗科收治直肠癌切除手术后患者43例,随机分为3DCRT组和IMRT组,进行CT扫描、靶区和危及器官的勾画,进行3DCRT和IMRT计划设计,对患者予以相应治疗后收集数据进行分析。结果 3DCRT和IMRT治疗计划均能满足处方剂量要求;IMRT靶区适形度指数CI(0.93±0.15)和剂量均匀性指数HI(0.168±0.036)均优于3DCRT组(0.73±0.1,0.218±0.083)(P<0.01)。3DCRT组股骨头(V30,V50)、小肠(V50)、膀胱(V40,V50)、骨盆(V50)均显著高于IMRT组(P<0.01),3DCRT组骨盆(V20)高于IMRT组(P<0.05),而小肠(V15)两组之间差异无显著性(P>0.05)。IMRT在下消化道骨髓抑制和泌尿系统指标均优于3DCRT,差异具有显著性(P<0.01)。结论 3DCRT和IMRT治疗计划均可满足直肠癌靶区处方剂量要求,但IMRT较3DCRT技术有剂量学方面的优越性,且具有更低的毒副作用。[Objective] To evaluate the dosimetrie and toxicity characteristics of intensity-modulated radiation therapy （IMRT） and three-dimensional confmnal radiation therapy （3D-CRT） for postoperative radiotherapy of rectal cancer. [Methods] 43 cases of patients in coloreetal cancer surgery in our hospital were randomly divided into 3DCRT and IMRT group, CT simulation orientation, and sketched a target area and threaten the organs, designed 3DCRT and IMRT plan. After corresponding treatment, data was collected for analysis. [Results] All plans met the needs of the prescribed doses; IMttT target eonformal index CI （0.93 ＋0.15） and dose uniformity index HI （0.168 ＋ 0.036） were better than 3DCRT group （0.73＋0.13, 0.13 ＋ 0.73）（P 〈0.01）. 3DCRT group （femoral head V30, V50）, small intestine （V50）, bladder （V40, V50）, pelvic （V50） were significantly higher than that in IMRT group （P 〈0.01）, 3DCRT pelvis （V20） higher than that in IMRT group （P 〈0.05）, and the intestinum tenue （V15） no statistically dif- ference between two groups （P 〉0.05）. In digestive tract and urinary systems indexes, IMRT superior over3DCRT group with a significant difference （P 〈0.01）. [ Conclusion] 3DCRT and IMRT treatment plan could meet the re- quirements of target prescription dose in rectal eaneer, but compared to 3DCRT, IMRT technology has the superiori- ty of dosimetry and lower side effects.

关 键 词：直肠癌 3DCRT IMRT 剂量 毒性 

分 类 号：R735.37[医药卫生—肿瘤]