顶枕叶胶质瘤非共面三维适形放疗与调强放疗的剂量学对比研究  

Dosimetric comparison of IMRT and non-coplanar beam in 3D-CRT for parietal-occipital lobe of brain gliomas

作　　者：苏琼菲[1] 王希成[1] 

机构地区：[1]广东药学院附属第一医院肿瘤科,广东广州510080

出　　处：《中华肿瘤防治杂志》2015年第8期614-617,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的比较顶枕叶脑胶质瘤非共面三维适形放疗(three-dimensional conformal therapy,3D-CRT)与调强放疗(intensity modulated radiation therapy,IMRT)对靶区剂量分布及周围正常组织的影响,为临床应用提供参考。方法选择2010-07-01-2012-08-01广东药学院附属第一医院肿瘤科顶枕叶脑胶质瘤患者8例,每例患者分别设计非共面3D-CRT及IMRT计划。比较两种放疗计划的靶区剂量学特点以及脑干、视交叉和视神经等正常组织的受照射剂量及体积。结果 IMRT计划中靶区覆盖V95(98.40±1.04)优于3D-CRT(96.27±0.64),差异有统计学意义,P<0.001。两组计划的适形指数(conformity index,CI)相仿,差异无统计学意义,P>0.05;IMRT计划中的均匀指数(homogeneity index,HI)值(1.03±0.009 0)小于3D-CRT的HI值(1.05±0.006 5),差异有统计学意义,P<0.05。IMRT计划中脑干D5、Dmean和Dmax与3D-CRT的参考指标比较差异无统计学意义,P>0.05。其他危及器官视交叉、视神经、垂体、晶体及眼球,IMRT计划受量大于3D-CRT的,差异均有统计学意义,P值均<0.05。IMRT计划中正常脑组织V24Gy(42.32±6.08)、V18Gy(45.82±6.15)大于3D-CRT(35.01±6.86,39.33±7.21),P<0.05。结论顶枕叶胶质瘤,IMRT与3D-CRT均能满足靶区要求及保护危及器官,虽然IMRT在靶区覆盖率、均匀性方面优于3D-CRT,但同时也增加了正常脑组织的照射剂量。OBJECTIVE To compare the dosimetric differences of target and the influence of normal tissue of Inten- sity Modulated Radiation Therapy（IMRT） and non-coplanar beam in Three-Dimensional Conformal Therapy（3D-CRT） for parietal-occipital lobe of Brain Gliomas treatment planning,and provide references. METHODS We retrospectively se- lected 8 patients whose tumors were located within parietal-occipital lobe. For each patient, a non-coplanar beam in 3D-CRT plan and an IMRT plan were generated in 3D-TPS. We compared dose distribution of target（dose conformity and heterogeneity index） ,organs at risk （such as brainstem,Chaism）and normal tissue between the two plans. RESULTS The average V95 in the IMRT plan （98.40±1.04） was more than in 3D-CRT plan （96.27±0.64,P〈0. 001）. The CI in the two kinds of plans was almost close and the difference was no statistical significance. The average HI in the IMRT plan （1.03±0. 009 0） was less than in 3D-CRT plan （1.05±0. 006 5,P〈0.05）. The differences of Ds ,D and Dmax of brain- stem in the two plans were no significance. In other OARs, including chaism, optic nerve, pituitary, eye, len, the IMRT plan were more than in 3D-CRT plan（P〈0.05）. For the normal brain tissues, with low-dose volume, IMRT increased V24 Gy （42.32±6.08）,V18Gy（45.82±6.15） with3D-CRT （35.01±6.86,39.33±7.21,P〈0.05）.CONCLUSIONS For parie- tal-occipital lobe tumors,both IMRT and 3D-CRT can be good to satisfy the requirement of target and the protective of OARs. Although IMRT is superior to 3D-CRT at the target coverage and homogeneity, but IMRT increase the low-dose volume of normal brain tissues with 3D-CRT.

关 键 词：顶枕叶胶质瘤 三维适形放疗 调强放疗 剂量学 

分 类 号：R739.41[医药卫生—肿瘤]