不同射野方向和数目对宫颈癌术后静态调强放射治疗计划的剂量学比较研究  

Comparative study on static IMRT plan with different incident direction and beam number in postoperative patient with cervical carcinomas

作　　者：曾华驱 温尊北[2] 陈宗友[1] 林启富[1] 梁柱[1] 汤树奎 ZENG Hua-qu;WEN Zun-bei;CHEN Zong-you;LIN Qi-fu;LIANG Zhu;TANG Shu-kui(,Radiotherapy Center;Department of Oncology,Gaozhou People＇s Hospital,Gaozhou 525200,Guangdong,China)

机构地区：[1]高州市人民医院放疗中心,广东高州525200 [2]高州市人民医院肿瘤内科一区,广东高州525200

出　　处：《生物医学工程与临床》2018年第4期439-443,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的比较宫颈癌术后不同射野方向和射野数目的静态调强放射治疗(IMRT)计划对靶区和危及器官的剂量分布,以及计划的机器跳数和子野数,以便确定较优的静态IMRT计划。方法随机选择10例宫颈癌术后患者,年龄44~64岁,中位年龄54岁。为每例患者设计6种静态IMRT计划,给予处方剂量50 Gy/2 Gy/25 f,所有计划都满足靶区目标剂量覆盖靶区体积达到95%。6种静态IMRT计划分别命名为5F-IMRT-0、5F-IMRT-180、7F-IMRT-0、7F-IMRT-180、9F-IMRT-0、9F-IMRT-180。分别比较每种计划的靶区最大剂量、最小剂量、平均剂量、均匀性指数,危及器官受照剂量,以及计划的机器跳数和子野数目。结果6种静态IMRT计划临床靶区(CTV)的最大剂量、最小剂量、平均剂量、均匀性指数的差异无统计意义(P>0.05)。对于脊髓,5F-IMRT-180计划比9F-IMRT-180计划平均高327.8 Gy(t=2.706,P=0.03);与其他IMRT计划差异无统计学意义(P>0.05);9F-IMRT-180计划的受照剂量最低。对于膀胱,6种静态IMRT计划相互之间的平均受照剂量Bladder_(mean)、V_(50)差异无统计学意义(P>0.05),但9F-IMRT-180计划相对于其他5种静态IMRT计划的平均受照剂量Bladder_(mean)、V_(40)受照体积都要低。对于直肠,6种静态IMRT计划的平均受照剂量Rectum_(mean)、V_(50)差异无统计学意义(P>0.05),但9F-IMRT-180计划的平均受照剂量Rectum_(mean)、V_(40)和V_(50)都较低。对于左股骨头,6种IMRT计划相互之间平均受照剂量差异无统计学意义(P>0.05),但9F-IMRT-180计划的平均受照剂量、V_(25)和V_(35)都较低。对于右股骨头,6种IMRT计划中,5F-IMRT-0计划的平均受照剂量和V_(25)都是最高的(P<0.01);但5F-IMRT-180、7F-IMRT-0、7F-IMRT-180、9F-IMRT-0、9F-IMRT-180 5种计划受照剂量相互之间差异无统计学意义(P>0.05)。6种静态IMRT计划的危及器官受照剂量、机器跳数、子野数差异有统计学意义(P<0.05)。结论6种静态IMRT计划中,5F-IMRT-0计划相对�Objective To compare the dose distribution of the target area,organ at risk（OAR）,monitor unit and the number of segment of static intensity modulated radiation therapy（IMRT）in six plans with different incident direction and bean number in postoperative patient with cervical carcinomas,and find better static IMRT plan.MethodsA total of 10 postoperative patients with cervical carcinomas were enrolled,which aged 44-64 years old with mean age of 54 years old.Six static IMRT plans were designed and prescribed dose was 50 Gy/2 Gy/25 f.Ninety-five percent of target volume received（i.e.D_（95）=50 Gy）.The six static IMRT plans were named 5F-IMRT-0,5F-IMRT-180,7F-IMRT-0,7F-IMRT-180,9F-IMRT-0 and 9F-IM-RT-180,respectively.The max dose,min dose,mean dose,homogeneity index of target,the received dose of OAR,the monitor unit and the number of segments of each plan were compared.Results There were no statistical significance（P〉0.05）differences of max dose,min dose,mean dose and homogeneity index of target in six static IMRT plans.For spinal cord,5F-IM-RT-180 was 327.8 Gy higher than that of 9F-IMRT-180（t=2.706,P=0.03）,while it had no significant difference with other IMRT plans（P〉0.05）.The 9F-IMRT-180 plan had the lowest exposure dose.For bladder,there was no significant difference in mean irradiated dose of Bladder_（mean）and V_（50）of six static IMRT plans（P〉0.05）,while 9F-IMRT-180 plan showed lower irradiated doses of Bladder_（mean）and V_（40）than other five static IMRT plans.For rectum,there was no statistically significant difference in mean rectal mean doses of Rectum_（mean）and V_（50）of six static IMRT plans（P〉0.05）,but rectal mean doses Rectum_（mean）,V_（40）and V_（50）were lower in 9F-IMRT-180 plan.For left femoral head,there was no statistically significant difference in mean dose of six IMRT plans（P〉0.05）,but mean dose,V_（25）,and V_（35）of 9F-IMRT-180 plan were lower.For right femoral head,the mean dose of irradiation and V_（25）o

关 键 词：宫颈癌 适形放射治疗 调强放射治疗 剂量学 最大剂量 最小剂量 

分 类 号：R319[医药卫生—基础医学]