斗篷野三维适形放疗和调强放疗治疗霍奇金淋巴瘤计划剂量对比分析  

Dosimetric comparison of three-dimensional conformal radiotherapy plan and intensitymodulated radiotherapy plan for the mantle field of patients with hodgkin's lymphoma

作　　者：彭莹莹[1] 张书旭[1] 谭剑明[1] 张国前[1] 周祥[1] 

机构地区：[1]广州医科大学附属肿瘤医院放疗中心,广东广州510095

出　　处：《中国医学物理学杂志》2015年第4期582-585,共4页Chinese Journal of Medical Physics

摘　　要：目的:研究斗篷野三维适形放疗技术(3DCRT)和调强放疗技术(IMRT)治疗霍奇金淋巴瘤的剂量学差异以探讨最佳计划设计方案。方法:选择12例霍奇金淋巴瘤,采用PINNACLE V9.2三维放射治疗计划系统对每例患者分别制定2野3DCRT计划和2野、5野、7野IMRT计划,分析各治疗计划PTV的最大剂量(Dmax)、最小剂量(Dmin)、平均剂量(Dmean)、靶体积适形指数(CI)、均匀指数(HI)以及肺、脊髓、心脏等正常组织受量的差异。结果:(1)2野IMRT和2野3DCRT计划的适形指数分别为(0.42±0.06)、(0.45±0.06),差异无统计学意义(P>0.05),5野、7野IMRT计划的适形指数分别为(0.63±0.08)、(0.59±0.07),明显优于2野3DCRT计划,差异有统计学意义(P<0.05);(2)2野、5野、7野IMRT计划的均匀指数分别为(1.06±0.05)、(1.06±0.07)、(1.03±0.05),均优于2野3DCRT计划(1.13±0.08)(P<0.05);(3)2野IMRT和2野3DCRT计划的肺组织受量各参数均无显著差异,2野IMRT计划的肺受量V5、V10均明显优于5野、7野IMRT计划(P<0.05),但V20、V30差异无统计学意义(P>0.05);(4)4种计划的脊髓、心脏、喉等正常组织受量均在耐受剂量范围之内。结论:2野IMRT计划靶区均匀性优于2野3DCRT计划,肺组织受照剂量优于5野、7野IMRT计划。因此霍奇金淋巴瘤斗篷野放疗建议选用2野IMRT计划。Objective To discuss on the best treatment plan by comparing the dosimetric differences between three-dimensional conformal radiotherapy （3DCRT） and intensity-modulated radiotherapy （IMRT） for the mantle field of patients with Hodgkin＇s lymphoma. Methods Twelve patients with Hodgkin＇s lymphoma were selected. Two-field 3DCRT plan and two-field, five- field and seven-field IMRT plans were respectively designed for each patient by PINNACLE V9.2 3D radiotherapy planning system. The maximum dose （Dmax）, minimum dose （Dmin）, mean dose （Dmean） of planning target volume （PTV）, conformal index （CI）, homogeneity index （HI） and the dose to the normal tissues of lungs, spinal cord, heart and so on were analyzed. Results The CI of two-field IMRT plan and two-field 3DCRT plan was （0.42±0.06） and （0.45±0.06） respectively, without statistical differences （P〉0.05）, while the CI of five-field IMRT plan and seven-field IMRT plan was （0.63±0.08） and （0.59±0.07） respectively, obviously better than that of two-field 3DCRT, with statistical differences （P〈0.05）. The HI of two-field, five- field, seven-field IMRT plans was （1.06±0.05）, （1.06±0.07） and （1.03±0.05）, respectively, which were significantly better than that of two-field 3DCRT （1.13±0.08） （P〈0.05）. There were no statistical differences in the dose to lung tissues between two- field IMRT and two-field 3DCRT （P〉0.05）. Among the two-field IMRT plan, five-field IMRT plan and seven-field IMRT plan, the lung V5 and V50 in two-field IMRT plan were lower than those in five-field IMRT plan and seven-field IMRT plan, with significant differences （P〈0.05）, but no statistical differences were found in the lung V20 and V30 （P〉0.05）. All the doses to the normal tissues of spinal cord, heart and throat in these four treatment plans were in the range of their tolerance doses. Conclusion The homogeneity of the target volume in two-field IMRT plan is significantly better than that in

关 键 词：霍奇金淋巴瘤 三维适形放疗 调强放疗 斗篷野放疗 剂量比较 

分 类 号：R815.2[医药卫生—放射医学] R730.55[医药卫生—临床医学]