全中枢神经系统调强放疗技术的应用  

Application of Intensity-modulated Radiotherapy for Carniospinal Irradiation

作　　者：谢秋英[1] 石锦平[1] 张利文[1] 滕建建[1] 胡学锋[1] 

机构地区：[1]佛山市第一人民医院肿瘤中心放疗科,528000

出　　处：《实用癌症杂志》2014年第6期712-715,共4页The Practical Journal of Cancer

摘　　要：目的探索调强放射治疗技术在改善全中枢放疗整体靶区剂量分布均匀性方面的应用价值.方法对6例全中枢放射治疗患者,分别采用常规适形技术（CRT）和调强射野叠加逆向优化技术进行计划设计.对比2种方法靶区、正常组织剂量分布和衔接区域剂量均匀性差异.结果调强组的靶区整体剂量覆盖和剂量均匀度均得到显著改善.靶区体积各项指标D98%、D2%、V95%、V110%分别为IMRT（95.2%、113.8%、98.1%、11.9%）,优于常规组（89.7%、124.1%、88.6%、25.4%）,脊髓剂量均匀性由57.7% ～118.5%提高到96.5% ～108.8%,各项指标差异均具有统计学意义,P值均〈0.01.±5mm的头脚方向摆位误差引起衔接区域脊髓中轴剂量变化范围从常规组的160% ～35% 降低到110% ～95%.结论采用调强射野叠加优化技术可明显改善靶区剂量适形度和均匀性,并能有效减小摆位误差对衔接区域剂量的影响.Objective To explore the application value of IMRT technology in improving the dose homogeneity of overall target for carniospinal irradiation. Methods 6 craniospinal irradiation patients received 2 different treatment plans,including conventional CRT plan and IMRT plan with overlying-field optimizing. Dose distribute to the tumor targe and OAR,and the dose homogeneity of the match zone of the 2 plans were compared. Results The target volume coverage and the dose homogeneity was superior for the IMRT plan. The mean of D98% 、D2% 、V95% 、V110% for the target in IMRT group were 95. 2% 、113. 8% 、98. 1% 、11. 9%,and in conventional CRT group were 89. 7% 、124. 1% 、88. 6% 、25. 4%. The dose homogeneity of spinal cord was improved from 57. 7% ~ 118. 5% to 96. 5% ~ 108. 8%. The P value of each assessment indicators was less than < 0. 001,there had a significant difference. The central axis dose variation of the spinal match zone,caused by ± 5 mm longitudinal positioning error,was reduced from the CRT 160. 0% ~ 35. 0% to 110. 0% ~ 95. 0%. Conclusion The IMRT overlying-field optimizing technique can obviously improve the dose conformity in the target and the dose homogeneity in the match zone,and can effectively reduce the influence of setup error to the dose homogeneity in the match zone.

关 键 词：全中枢 衔接 调强放疗 剂量分布 

分 类 号：R730.55[医药卫生—肿瘤]