两种全中枢神经系统放疗技术患者有效剂量的比较  

Comparative analysis of effective dose between helical tomotherapy and multi-ISO radiotherapy in craniospinai irradiation

作　　者：廖雄飞[1] 李厨荣[1] 黎杰[1] 陈亚正[1] 袁珂[1] 王培[1] 

机构地区：[1]四川省肿瘤医院·研究所四川省癌症防治中心电子科技大学医院,成都610041

出　　处：《中华放射医学与防护杂志》2017年第1期45-49,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的比较螺旋断层放疗（helical tomotherapy，HT）和多等中心放疗（multi—ISO radiotherapy，M—ISO）两种技术在全中枢神经系统放疗（craniospinal irradiation，CSI）过程中患者的有效剂量。方法选取在本院已接受全中枢神经系统放射治疗的9例儿童患者，分别运用螺旋断层放疗和多等中心放疗两种技术对此9例患者重新进行治疗计划设计。对9例患者共18个治疗计划的患者有效剂量进行计算，运用配对t检验比较两种放疗技术过程中患者有效剂量的差异。结果HT和M—ISO计划均满足临床要求，两组计划靶区剂量D95%差异无统计学意义（P〉0．05）；HT组的D98%、D22%、均匀性指数（HI）优于M—ISO计划（t=2．762、2．413、4．563，P〈0．05）；M—ISO组的D50％、Dmean和适形指数（CI）优于HT计划（t=5．259、3．685、7．815，P〈0．05）。两种计划方法对危及器官的保护各有优势；9例患者全身有效剂量HT计划高于M-ISO计划，差异有统计学意义（t=5．921，P〈0．01）。结论HT与M—ISO两种技术在全中枢神经系统放疗中各有优势，HT组计划低剂量区域范围对于患者有效剂量影响较大，全中枢放疗计划设计时应关注低剂量辐射范围。Objective To compare the effective dose deposited in patients between helical tomotherapy （HT） and muhi-ISO radiotherapy （M-ISO） in carniospinal irradiation （CSI）. Methods Nine children with craniospinal irradiation were selected. For these patients, new plans were designed with HT and M-ISO centers planning method on the treatment planning system （TPS）. The effective dose of the nine patients from 18 treatment plans were calculated,and the difference of the effective dose between HT and M-ISO was compared using paired t-test. Results The plans designed in two groups were both satisfied all clinical requirements. For the planning target volume （PTV）, no statistically significant difference was foundin D95 % between two groups （ P 〉 0.05 ） , while D98 % , D2% and homogeneity index （HI） in HT group were superior to M-ISO group （t = 2. 762, 2. 413, 4. 563, P 〈0.05） , D50% , D and CI in M-ISO group were superior to HT group （t =5. 259, 3. 685, 7. 815, P 〈0.05）. HT and M-ISO had different advantages in the protection of the OARs. The effective dose of patients in M-ISO group was superior to HT group （t = 5. 921, P 〈 0. 05 ）. Conclusions HT and M-ISO have different advantages in CSI. The low dose area has greater influence on the effective dose in HT group compared to M-ISO group. The low dose area should be concerned while designing the treatment planning for CSI.

关 键 词：全中枢神经系统 螺旋断层放疗 多等中心放疗 有效剂量 

分 类 号：R730.55[医药卫生—肿瘤]