肝癌四维CT放疗计划设计方式探讨  

Based on liver cancer four-dimensional CT explore the way of treatment plan design

作　　者：卿珍[1] 邢立刚[2] 尹勇[2] 王慧玲[3] 方浩[3] 赵海[3] 张爱萍[1] 韩军[1] 

机构地区：[1]大连现代高技术集团有限公司,辽宁大连116025 [2]山东省肿瘤医院,济南250117 [3]浙江工业大学,杭州310014

出　　处：《现代仪器与医疗》2015年第3期4-6,9,共4页Modern Instruments & Medical Treatment

基　　金：国家国际科技合作专项资助项目;编号2012DFA10700

摘　　要：目的 :通过与标准流程制作的4D放疗计划剂量分布对比分析,探讨四维计划设计过程简化可行性。方法 :选取原发性肝癌患者10例,每例患者都采用两种方案进行4D放疗计划设计,分别定义为准4D计划和4D计划。两种方案基于相同的4D轮廓勾画方式、射野方向和处方剂量,准4D计划在参考时相上进行布野及射野优化,而4D计划在各个时相上各自进行优化,然后变形叠加到参考时相。最终对比分析两种方案的剂量差异。结果 :在肝癌危及器官保护和处方剂量提升方面,4D计划都略优于准4D计划,但无统计学意义差异。结论 :临床应用肝癌的四维放射治疗技术,可以对4D计划优化过程进行部分简化,提高该技术临床应用的可操作性。但对于个别呼吸幅度较大或靶区与危及器官结构相对复杂患者,需要后续研究中进一步探讨。Objective： By comparing the dose difference with the standard process of making 4D radiotherapy, explore the possibility of simplify the standard four-dimensional plan design process. Methods： Select a total of ten cases of primary hepatocellular carcinoma patients, each patient using two way of 4D plan design, defined as quasi 4D plan and 4D plan. Two schemes are based on the same 4D contouring way, beam direction, Prescription dose, but the quasi 4D plan optimize field parameters in the reference phase, and the 4D plan optimize field parameters in each phase, and then superimposed deformation to the reference phase. Finally, analysis the dose difference of two schemes. Results： In the liver organ at risk protection and prescription dose increase, 4D plans are slightly better than the quasi 4D plan, but the change was not significant. Conclusions： The clinical application of liver cancer four-dimensional radiation therapy, can be explored on 4D planning partially simplify the optimization process, improve the clinical operability. But for individual patient with larger respiratory amplitude, or target and OAR structure is relatively complex, follow- up studies need to further explore.

关 键 词：4D CT 呼吸时相 计划优化 四维放射治疗 原发性肝癌 

分 类 号：R445[医药卫生—影像医学与核医学]