宫颈癌IMAT与IMRT疗效比较研究  

Cervical Cancer Intensity Modulated Arc Therapy Application Research

作　　者：张若辉 白文文[1] 樊晓妹[2] 李润宵 邱嵘[1] 曹艳坤 迟子锋[1] 牛书怀[2] 

机构地区：[1]河北医科大学第四医院放射治疗科,河北石家庄050011 [2]河北医科大学第四医院妇瘤科,河北石家庄050011

出　　处：《医学与哲学（B）》2015年第10期37-40,共4页Medicine & Philosophy(B)

摘　　要：通过比较宫颈癌静态调强放疗(IMRT)与旋转调强放疗(IMAT)计划,分析在瓦里安Clinical 23IX加速器实施IMAT技术治疗宫颈癌的优缺点。选取18例在本院Clinical 23IX加速器进行IMRT治疗的宫颈癌术后患者重新设计IMAT计划。使用Oncentra 4.1计划系统,模拟处方剂量为50.4Gy分28次。通过剂量体积直方图(dose volume histograms,DVH)统计PTV,CTV和外危及器官(organs at risk,OAR)剂量体积参数以及治疗机器跳数(MU)和治疗时间。用SPSS 19.0软件对2个组数据进行配对T检验分析。显示IMAT计划组PTV的适形指数(CI),CTV的均匀指数(HI)、CI、D90、D95、D98、V95、V98、V100,脊髓D2和直肠V40以及治疗时间和治疗MU均优于IMRT组。IMRT计划组在降低膀胱V50,小肠V30以及低剂量受照区域要优于IMAT组。在瓦里安Clinical 23IX加速器设计的宫颈癌患者IMAT计划可以达到与IMRT相似或更好的剂量学分布,治疗时间短,MU少,可减少治疗中不确定性因素影响及患者不适感。Comparing the characteristics of static intensity modulated radiotherapy （IMRT） and intensity modulated arc therapy （IMAT） in the treatment of cervical cancer, analysis of the feasibility of implementation of IMAT technique on Varian Clinical 23IX. 18 cervical cancer patients treated with IMRT on Varian 23IX were replanted using IMAT. The plans were generated on Oncentra v4. 1 planning system, PTV was prescribed to 50. 4 Gy in 28 fractions. Plans were evaluated based on the ability to meet the dose volume histogram. The homogeneity index （HI）, conformity index （CI） of target volume, the dose of organs at risk, radiation delivery time and monitor units were also compared. SPSS 19. 0 software paired T-test analysis was carried out on the two sets of data. Compared with the IMRT plans PTV＇s CI , CTV＇s CI, HI, D90, D95, D98, V95, V98, V100 , and cord D2 and rectum V40 , and treatment time and MU were better than that of IMRT group. But the IMRT plans in terms of decreasing bladder V50, bowel V30 and low dose irradiation volume were superior to that of IMAT plans. There were no significant differences in other statistical index. Cervical cancer patients with IMAT on Varian Clinical 23IX can get equivalent or superior dose distribution compared with the IMRT technology. IMAT have much less treatment time and MU can reduce the uncertainty factor and patient discomfort in treatment.

关 键 词：宫颈肿瘤/放射疗法 旋转调强放疗 静态调强放疗 剂量学 

分 类 号：R737.33[医药卫生—肿瘤]