三维适形调强放疗在海马区保护中的应用  

The application of intensity modulated radiotherapy in the protection of hippocampus

作　　者：蒋朝阳[1] 向艳[1] 张伶[1] 潘兴国[1] 咸婧[1] 

机构地区：[1]成都军区总医院肿瘤诊治中心放疗科,四川成都610083

出　　处：《现代肿瘤医学》2016年第2期285-287,共3页Journal of Modern Oncology

摘　　要：目的:探讨三维适形调强放疗(IMRT)在海马区保护性放疗中的应用。方法:选择10例肺癌脑转移患者进行CT及MRI定位扫描,并由主治医师勾画出颅脑放疗的靶区,每例患者均由物理师设计两组相同照射野的全脑三维适形调强放疗计划,实验组(A组)为海马区保护性放疗组,对照组(B组)则对海马区受量不做任何限制。两组单次剂量均为3Gy共计放疗10次,最后均以95%PTV体积获得30Gy的处方剂量进行剂量归一,再利用剂量体积直方图(DVH)对两组海马区及全脑受量进行分析,其中海马区受量的分析选择其最大剂量点(D_(max))及体积分别为30%、40%、50%、60%时的照射剂量。结果:和对照组(B组)比较,海马区受量除最大剂量点(D_(max))外,其余数据均显著降低(P<0.000 1)。结论:在颅脑肿瘤的放疗中,调强放疗能在保证全脑受量的同时显著降低双侧海马区的受量,但海马区最大剂量点降低不明显。Objective： To investigate the application of intensity modulated radiotherapy（ IMRT） in the protection of hippocampus. Methods： Ten patients of lung cancer with brain metastases received CT and MRI scanning in order that the attending physician can contoured their target area. Then designed two groups of IMRT plan with the same fields. The experimental group（ group A） was for the protection of hippocampus. The control group（ group B） without any restriction on the dose of hippocampus. 3Gy per fraction and 10 fractions in total for both group A and B. And finally normalized the 30 Gy prescription dose attained by 95% of the PTV volume. Compared the following parameter in the two plans by using the dose volume histogram（ DVH） ： The maximum dose of hippocampus（ D_（max））. Results： Compared with group B,except the maximum dose of hippocampus（ D_（max））,the rest of the data were significantly decreased in group A（ P〈0. 000 1）. Conclusion： Intensity modulated radiotherapy can not only guaranteed the whole brain irradiation dose,but also significantly reduce the dose of bilateral hippocampus,but it seems that the maximum dose not significantly decreased in hippocampus.

关 键 词：调强放疗 海马区 剂量分布 

分 类 号：R730.55[医药卫生—肿瘤]