前列腺癌旋转容积调强放射治疗与固定野动态调强放射治疗的剂量学比较  

Dosimetric comparison between rotational volume enhancement therapy and fixed-gantry dynamic intensity modulated radiation therapy in prostate cancer

作　　者：陈婷婷[1] 花威[1] 张西志[1] 汪步海[1] 

机构地区：[1]苏北人民医院肿瘤科,江苏扬州225001

出　　处：《生物医学工程与临床》2017年第6期624-628,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的运用旋转容积调强放射治疗(瓦里安Rapid Arc)与固定野动态调强放射治疗(dIMRT)技术,比较前列腺癌放射治疗计划中的剂量学差异。方法选择9例前列腺癌患者,年龄57~71岁,中位年龄63岁;T_2期5例,T_3期4例。分别设计Rapid Arc、dIMRT放射治疗计划,运用剂量体积直方图,对两种计划中临床靶区(CTV)和危及器官的剂量学差异进行比较。结果Rapid Arc技术与dIMRT技术相比,其CTV和计划靶区(PTV)适形指数、靶区剂量均匀性指数更加接近1,最小值D_(98%)也更加接近处方剂量(P<0.05);在Rapid Arc计划方案中膀胱和直肠的V_(20)、V_(30)略高于dIMRT计划(P<0.05),但仍满足各自的剂量限值要求;V_(40)、D_(mean)差异无统计学意义(P>0.05)。Rapid Arc计划方案中股骨头的D_(5%)显著高于dIMRT计划方案(P<0.05);Rapid Arc计划方案中治疗时间仅为dIMRT的1/3左右。结论Rapid Arc计划方案能够达到甚至优于dIMRT计划方案的靶区剂量分布,可以满足前列腺癌放射治疗的临床剂量要求,同时其具有较少总治疗时间的优势。Objective To compare dosimetric differences between rotational volume enhancement therapy（Rapid Arc）and fixed-gantry dynamic intensity modulated radiation therapy（dIMRT）for prostate cancer radiotherapy.Methods A total of 9patients with prostate cancer were enrolled,which aged 57-71 years old with median age of 63 years old.Among these patients,5 cases were in T2stage and 4 were in T3stage.The Rapid Arc and dIMRT plans were performed,and dose volume histograms were used to compare the dose differences of clinical target volume（CTV）and organ at risk between 2 radiotherapy plans.Results Compared with dIMRT plan,the conformal index and homogeneity index of CTV and planning target volume（PTV）in Rapid Arc plan were closed to 1,the minimum value of D（98%）was also closed to prescription dose（P〈0.05）.In Rapid Arc plan,the V（20）,V（30）of bladder and rectum were slightly higher than those of dIMRT plan（P〈0.05）,but still met the dose limits.There were no significant differences in V（40）and D（mean）（P〈0.05）.The D（5%）of femoral head in Rapid Arc plan was significantly higher than that of dIMRT plan（P〈0.05）.The treatment time of Rapid Arc plan was only about 1/3 of dIMRT plan.Conclusion It is demonstrated that Rapid Arc plan could meet or even better than dIMRT plan in target dose distribution,which could satisfy the clinical requirements of dose radiotherapy in prostate cancer,while with less total treatment time.

关 键 词：前列腺癌 调强放射治疗 旋转容积调强(RapidArc) 固定野动态调强 剂量体积直方图 剂量学 

分 类 号：R730.55[医药卫生—肿瘤] R737.25[医药卫生—临床医学]