术中实时计划对腹膜后转移癌^(125)I粒子治疗的剂量学优势  

The advantages of intraoperative TPS real-time planning in treating retroperitoneal metastatic carcinoma with ^(125)I seed brachytherapy

作　　者：张利娟[1] 张宏涛[1] 王泽阳[1] 赵金鑫[1] 于慧敏[1] 王娟[1] 

机构地区：[1]河北省人民医院肿瘤一科,石家庄050000

出　　处：《介入放射学杂志》2017年第11期1011-1014,共4页Journal of Interventional Radiology

基　　金：河北省卫生厅医学适用技术跟踪项目(GL2014007)

摘　　要：目的探讨治疗计划系统(TPS)术中实时计划对CT引导下^(125)I放射性粒子治疗腹膜后淋巴结的必要性及可行性。方法回顾性分析2013年1月至2015年12月行CT引导下^(125)I放射性粒子治疗的20例腹膜后淋巴结转移癌患者的相关资料,其中10例行TPS术中实时计划指导(A组),10例未行TPS术中实时计划指导(B组),两组患者均行术前计划及术后质量验证。比较A、B两组手术前后90%靶体积的最小吸收剂量(D90)误差百分比、90%处方剂量覆盖的体积占靶体积的百分比(V90)误差百分比、100%处方剂量覆盖的体积占靶体积的百分比(V100)误差百分比、150%处方剂量覆盖的体积占靶体积的百分比(V150)误差百分比的差异。结果 A组手术前后的D90、V90、V100、V150的误差百分比分别为(-1.30±6.80)Gy、(-0.60±2.10)%、(-0.47±2.70)%、(89.60±282.00)%;B组手术前后的D90、V90、V100、V150的误差百分比分别为(-9.33±46.00)Gy、(11.50±13.70)%、(-13.40±15.90)%、(10.37±2.00)%。两组各参数相比较,其中D90、V90、V100误差百分比差异有统计学意义(P<0.05)。两组V150的误差百分比无统计学差异(P=0.247)。结论术中实时计划指导可显著提高粒子植入前后靶区剂量的一致性,使剂量分布更加合理,对腹膜后淋巴结转移癌^(125)I放射性粒子治疗的规范化具有重要价值。Objective To discuss the necessity and feasibility of intraoperative use of treatment planning system （TPS） to make real-time planning for the treatment of retroperitoneal metastatic carcinoma with CT-guided 125I seed brachytherapy. Methods The clinical data of 20 patients with retroperitoneal lymph node metastases, who received CT-guided 125I seed braehytherapy during the period from January 2013 to December 2015, were retrospectively analyzed. The patients were divided into group A （n=10） and group B （n=10）. The intraoperative TPS was employed to formulate the real-time planning for the patients of group A, while real-time planning was not adopted for the patients of group B. The quality verification of preoperative planning and postoperative effect was conducted for the patients of both groups. Comparing the preoperative and postoperative absorbed dose, the minimum absorbed dose （D90） error percentage of 90% target volume, the error percentage of the covered volume by 90% prescription dose to the target volume （V90）, the error percentage of the covered volume by 100% prescription dose to the target volume （V100）, and the error percentage of the covered volume by 150% prescription dose to the target volume （V150） were calculated in all patients of both groups, and the results were statistically analyzed. Results The mean error percentage of D90, V90, V100, V150 in group A were （-1.30±6.80） Gy, （-0.60±2.10）%, （-0.47±2.70）% and （89.60±282.00）% respectively, which in group B were （-9.33±46） Gy, （11.50±13.7）%, （-13.40±15.90）% and （10.37±2.00）% respectively. The differences in the error percentage of D90, V90 and V100 between group A and group B were statistically significant （P〈0.05 in all）, while no statistically significant difference in the error percentage of V150 existed between group A and group B （P〉0.05）. Conclusion The use of intraoperative TPS real-time planning can significantly improve the consistency of target region dose b

关 键 词：腹膜后淋巴结 术中实时计划 125I放射性粒子 

分 类 号：R735.4[医药卫生—肿瘤]