不同放射治疗技术治疗肝癌的剂量学特征比较研究  

Comparatic study of different radiotherapy techniques in the treatment of hepatocellular carcinoma

作　　者：雷占全[1] 

机构地区：[1]解放军第174医院(厦门大学附属成功医院)放疗科,福建厦门361003

出　　处：《中国医学装备》2016年第9期70-73,共4页China Medical Equipment

摘　　要：目的:比较三维适形放射治疗(3D-CRT)、适形调强放射治疗(IMRT)和简化调强放射治疗(s IMRT)技术治疗原发性肝癌的剂量学特点,为临床提供最优放射治疗计划方案。方法:选择原发性肝癌患者10例,分别制定4野3D-CRT、4野IMRT及4野s IMRT放射治疗计划,处方剂量为50 Gy/20次,通过剂量体积直方图(DVH)分析比较3种计划的靶区剂量均匀度指数(HI)、适形度指数(CI)、机器跳数及危及器官(OAR)照射剂量。结果:通过s IMRT分别与3D-CRT和IMRT比较得到:靶区适形度指数IMRT最优,s IMRT次之,3D-CRT最差,其中s IMRT分别与3D-CRT和IMRT比较均有差异(t=4.95,t=4.32;P<0.05)。靶区不均匀指数IMRT最优,s IMRT次之,3D-CRT最差,其中s IMRT与3D-CRT和IMRT比较均有差异(t=3.42,t=4.02;P<0.05);正常肝组织低剂量照射区域、治疗时间、子野数目、治疗机总跳数及周边危及器官的保护方面:3D-CRT<s IMRT<IMRT。结论:s IMRT所具有的子野数少,面积大,机器跳数少,照射时间短及靶区适形度好等优势在原发性肝癌的放射治疗过程中具有较高的治疗增益比,值得推广。Objective To compare the dosimetry of three-dimensional conformal radiotherapy（3D-CRT）, intensity modulated radiotherapy （IMRT） and simplified intensity modulatedradiotherapy （sIMRT） for hepato-cellular cancer, in order to put forward the best radiation therapy plan. Methods：10 patients with hepatocellular carcinoma were designed 4 fields radiotherapy plan of 3D-CRT, IMRT and sIMRT,prescribed dose 50 Gy/20f, compared the target dose of homogeneity index （HI） and conformal index, monitorunit （MU）, the dose of organ at risk （OAR） of the 3 different radiotherapy techniques. Results： Compared sIMRTrespectively with 3DCRT and IMRT, target optimum conformal index IMRT was the optimal, sIMRT was the second,and 3D-CRT was the worst. The differences were statistically significant among them （t=4.95, t=4.32; P〈0.05）. Targethomogeneity index IMRT was the optimal, sIMRT was the second, and 3D-CRT was the worst. The differences werestatistically significant among them （t=3.42, t=4.02; P〈0.05 statistically significant）. The low dose irradiation area ofnormal liver, time of therapy, the child field number, the total MU and the protection of OAR： 3D-CRT〈sIMRT〈IMRT.Conclusion： sIMRT had better rate of radiotherapy and more advantages, such as less child fields, larger area, less MU,short irradiation time and better conformal target, which was worth popularizing.

关 键 词：原发性肝癌 三维适形放射治疗 适形调强放射治疗 简化调强放射治疗 

分 类 号：R730.55[医药卫生—肿瘤]