胃癌术后IMRT和VMAT计划的剂量学比较  

Dosimetric comparison of IMRT and VMAT plans for patients with postoperative gastric cancer

作　　者：徐莉霞[1] 李夏东[1] 章霓[1] 俞玉凤[1] 

机构地区：[1]杭州市肿瘤医院放疗科,浙江杭州310002

出　　处：《实用肿瘤杂志》2015年第2期154-156,共3页Journal of Practical Oncology

摘　　要：目的研究比较胃癌术后放疗中静态调强放疗(intensity-modulated radiotherapy,IMRT)计划和容积弧形调强放疗(volumetric modulated arc therapy,VMAT)计划在靶区剂量分布以及正常组织受量等方面的区别,比较两种计划的优缺点。方法选取10例胃癌术后放疗患者,勾画完靶区后,分别运用静态调强和动态调强制作计划,比较靶区的适形度、均匀性、脊髓的受量以及正常组织肝V5、V30、Dmean和双肾V12、V22、Dmean。结果 VMAT计划与IMRT计划比较,适应性和均匀性较好(均P<0.05),正常肝组织受量V5、V30、Dmean相对较低(均P<0.05),双肾受量和脊髓的最大受量两者差异无统计学意义(均P>0.05)。结论胃癌术后的VMAT计划靶区的适形度及均匀性优于IMRT计划。正常肝组织的受量相对较低,对保护肝组织有重要的意义。临床上用VMAT计划从剂量学及效率上都优于IMRT计划。Objective To compare the dose distribution in plan target and normal tissues between intensity- modulated radiotherapy （IMRT） and volumetric modulated arc therapy （VMAT） for patients with postoperative gastric cancer. Methods Ten postoperative patients with gastric cancer received IMRT and VMAT plans. The conformal index and homogeneity index of PTV,the dose volume V5 ,V30 and Dmean of liver tissue,the V12 ,V22 and Dmean of kidneys,and the maximum dose of spinal cord were compared between IMRT and VMAT. Results The conformal index and homogeneity index of VMAT were better than those of IMRT （both P 〈 0.05）. Dose in normal liver tissue in VMAT plan was lower than that in IMRT plan （ all P 〈 0. 05 ）. There were no significant differences in the dose of kidneys and spinal cord between two plans. Conclusion VMAT plan has more favorable clinical dosimetry and efficiency than IMRT plan for patients with postoperative gastric cancer.

关 键 词：胃肿瘤/放射疗法 手术后期间 放射疗法 调强适形 放射治疗剂量 

分 类 号：R735.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]