宫颈癌患者术后旋转调强与固定野调强放疗计划的剂量学比较  

Comparison of dosiology between intensity-modulated arc therapy plan and fixed field IMRT plan in patients with cervical cancer after operation

作　　者：刘翔宇[1] 王辉东[2] 郭明芳[3] 谢悦[4] 

机构地区：[1]重庆市肿瘤研究所资产设备部,重庆400030 [2]吉林大学第一医院放疗科,吉林长春130021 [3]重庆市肿瘤研究所妇瘤科,重庆400030 [4]重庆市肿瘤研究所放疗科,重庆400030

出　　处：《吉林大学学报（医学版）》2015年第4期850-853,共4页Journal of Jilin University：Medicine Edition

基　　金：重庆市卫生计生委医学科研计划项目资助课题(20140293)

摘　　要：目的:探讨宫颈癌患者术后放疗旋转调强放射治疗(IMAT)和固定野调强放射治疗(IMRT)剂量学的优劣,为其临床应用提供依据。方法:选择宫颈癌根治术后患者19例,行CT模拟定位,并勾画靶区及危及器官。在Eclipse 8.6计划系统上分别对每例患者设计IMAT和IMRT 2种放疗计划,评估靶区及危及器官的剂量学差异。结果:19例患者IMAT和IMRT放疗计划的设计时间分别为(129±3)和(30±1)min(P=0.000),在Varian IX加速器上的治疗时间分别为(3.17±0.23)和(6.55±0.17)min(P=0.009),靶区均匀指数(HI)分别为1.08±0.01和1.10±0.01(P=0.175),靶区适形指数(CI)分别为0.88±0.01和0.82±0.01(P=0.000)。IMRT计划的直肠、膀胱、小肠和股骨颈等危及器官受量接近或略小于IMAT。结论:与IMRT相比,IMAT在靶区剂量和CI有一定的优势,HI和危及器官受量两者较为接近,IMAT计划设计耗时增加了近3倍,治疗时间减少一半。临床上在计划设计时间充裕的前提下,建议尽量设计IMAT计划。Objective To explore the advantages and disadvantages of the intensity modulated arc therapy（IMAT）plans and intensity modulated radiation therapy（IMRT）plan,and to provide the basis for their clinical application.Methods 19 patients with cervical cancer after operation were selected.The patients were scanned by simulation CT,and the targets and organs at risk were contoured.IMAT plan and IMRT plan were designed respectively in Eclipse 8.6planning system.The treatment time and differences of the dose distribution in the targets and organs at risk of IMAT and IMRT plans were compared.Results The average design time of IMAT and IMRT plans of the19 patients was（129±3）and（30±1）min（P=0.000）;the average treatment time on Varian IX accelerator was（3.17±0.23）and（6.55±0.17）min（P=0.009）.The homogeneity index（HI）of targets were 1.08 ± 0.01 and 1.10 ± 0.01（P=0.175）.The conformal index（CI）of targets were 0.88 ± 0.01 and 0.82 ± 0.01（P=0.000）.IMRT plan had the smaller doses at rectum,bladder,small intestine and neck of femoral compared with IMAT.Conclusion Compared with IMRT,IMAT plan has the advantages in dose distribution at targets and CI,its HI and doses of organs at risk are almost same with IMRT.Compared with IMRT,the design time of IMRT plan is increased three times,and the treatment time is reduced by half.In clinic,if the planning time is affluent,the IMAT plan is recommended.

关 键 词：宫颈肿瘤 旋转调强放射治疗 固定野调强放射治疗 

分 类 号：R737.33[医药卫生—肿瘤]