复发胰腺癌和前列腺癌再放疗中脉冲式低剂量率(PLDR)调强治疗计划的设计和应用  

IMRT for Recurrent Pancreas and Prostate Cancer Using Pulsed Low Dose Rate Delivery Techniques

作　　者：黎杰[1] 康盛伟[1] 谭志博[1] 王俊超[1] 廖雄飞[1] 王培[1] 

机构地区：[1]四川省肿瘤医院放疗科,成都610041

出　　处：《肿瘤预防与治疗》2014年第3期120-125,共6页Journal of Cancer Control And Treatment

基　　金：四川省卫生厅项目;编号:090533

摘　　要：目的:设计一种用于复发的胰腺癌和前列腺癌放射治疗的PLDR-IMRT计划。方法:选择10例复发胰腺癌和10例复发前列腺癌患者,每个计划设置10个非共面射野,采用各种优化手段使得计划满足PLDR治疗的要求。并与三维适形(PLDR-3DCRT)计划和旋转调强(PLDR-ARC)计划比较。结果:胰腺癌PLDR-IMRT计划中,每个单独的射野中PTV的平均剂量在17.6cGy到22.4cGy之间,最大剂量的范围从22.9cGy到34.8cGy。前列腺癌病例中,PTV在每个单独的射野中的平均剂量在18.8cGy到22.6cGy之间,最大剂量的范围从24.0cGy到34.7cGy。IMRT计划中危及器官的剂量大大小于三维适形计划,接近旋转调强计划。结论:在脉冲式低剂量率放射治疗中,通过优化的设计,IMRT计划相对于通常使用的3DCRT计划更有优势,在保证靶区剂量的基础上降低了危及器官受量。Objective： To investigate the planning techniques for IMRT-based PLDR treatment for recurrent pan-creatic and prostate cancer cases. Methods：Ten cases of recurrent recurrent pancreatic and 10 cases of prostate cancer pa-tients were included in this study. Treatment plans were generated with 10 gantry angles using the step-and-shot delivery technique, which can be delivered in three-minute intervals to achieve an effective low-dose rate. The IMRT plans were compared with the 3DCRT plans and ARC plans. Results：For the ten pancreas cases investigated, the mean PTV dose for each gantry angle in the IMRT plans ranged from 17. 6 cGy to 22. 4 cGy. The maximum doses ranged between 22. 9 cGy and 34. 8 cGy. For the ten prostate cases investigated, the mean PTV doses for individual gantry angles ranged from 18. 8 cGy to 22. 6 cGy. The maximum doses per gantry angle were between 24. 0 cGy and 34. 7 cGy. A significant reduction in the OAR dose was achieved with IMRT compared with 3DCRT. Conclusion：Compared with 3DCRT, IMRT could provide superior target coverage and normal tissue sparing for PLDR reirradiation of recurrent pancreatic and prostate cancers.

关 键 词：再放疗 脉冲式低剂量率 调强放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R735.9[医药卫生—临床医学]