一种全颅全脊髓适形照射野的布野方案  

Field arrangement for conformal craniospinal radiotherapy

作　　者：张松方[1] 查元梓[1] 蒋马伟[1] 

机构地区：[1]上海交通大学医学院附属新华医院肿瘤科,上海200092

出　　处：《中国医学物理学杂志》2016年第3期301-303,316,共4页Chinese Journal of Medical Physics

摘　　要：目的:探讨一种简便易行、剂量准确性高的全颅全脊髓的适形照射的布野方案。方法:100多例髓母细胞瘤患者,俯卧位躺在特制的头颅固定器和真空负压袋上,进行CT模拟定位,在头颅放置3个标记点作为全颅野照射中心,进床30 cm左右作为全脊髓野的照射中心,通过多次改变全颅野的下界和脊髓野的上界来保证照射野内的剂量准确性。结果:经过上述方法设计的治疗方案,使得全颅全脊髓的放射治疗剂量分布精确,操作方便并且定位时间不长,临床疗效好。治疗时不在一个点上接野,确保脊髓的剂量无冷热点。结论:适形移动的全颅全脊髓的治疗技术操作方便,定位时间短,剂量分布准确,临床疗效好,副作用小,值得推广。Objective To investigate a new beam arrangement for conformal craniospinal radiotherapy, with simple and convenient operations, and high dose accuracy. Methods More than t 00 patients with medulloblastoma were selected and immobilized in prone position with a special head immobilization device and negative pressure vacuum bag for CT- simulation localization. Three radiopaque markers were put on the head as the radiation isocenter for the whole cranial field. The couch with longitudinal shift of 30 cm was taken as the radiation isocenter for the whole spinal field. The dose accuracy of the radiation field was assured by modifying the downer boundary of the whole cranial field and the upper boundary of the spinal field. Results The treatment plan designed by above-mentioned method ensured the accurate dose distribution of the craniospinal radiotherapy, with easy operations, moderate time for CT-simulation localization, and favorable clinical effect. The field junction was shifted during the treatment to ensure the dose of spinal cord without any cold or hot spots. Conclusion Craniospinal radiation technique with shifted junctions is worth to be popularized for its easy operations, short time for CT-simulation localization, accurate dose distribution, satisfactory clinical outcome and smaller side effect.

关 键 词：全颅全脊髓 布野 剂量 适形照射 脑部肿瘤 

分 类 号：R730.55[医药卫生—肿瘤]