中段食管癌序贯加量调强放疗与同步加量调强放疗的剂量学分析  

A dosimetric study of sequential boost intensity-modulated radiotherapy and simultaneously integrated boost intensity-modulated radiotherapy in midpiece esophageal carcinoma

作　　者：殷英[1] 杨林[1] YIN Ying;YANG Lin(Department of Radiotherapy,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院放疗科,安徽合肥230022

出　　处：《安徽医药》2018年第10期1912-1915,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较常规调强放疗与同步加量调强放疗的剂量学参数的差异。方法选择10例中段食管癌的患者,分别在计划系统上制定序贯加量调强放疗计划(SB-IMRT)和同步加量调强放疗计划(SIB-IMRT)。SB-IMRT是先给计划靶区(PTV)50Gy/25F,然后在大体肿瘤区(GTV)推量10 Gy/5F,SIB-IMRT是PTV区50 Gy/28F,同时给予GTV区60 Gy/28F。采用配对t检验方法比较两种计划的剂量学参数。结果 SIB-IMRT的适形指数CI(0.59±0.30)优于SB-IMRT(0.59±0.30)(P=0.000),但两者均匀指数HI差异无统计学意义(P=0.105)。SIB-IMRT的右肺的V_(20)、V_(30)、平均剂量(MLD),左肺的MLD以及心脏的V_(50)均低于SB-IMRT(统计值分别为P=0.012、P=0.007、P=0.002、P=0.001、P=0.003),两者在左肺的V_(20)、V_(30)以及脊髓最大受量差异无统计学意义(统计值分别为P=0.053、P=0.134、P=0.998)。结论在总物理剂量相同的情况下,相比序贯加量调强放疗,同步加量调强放疗的适形性更优,并且能减少部分危及器官的受量,尤其对肺脏和心脏的保护更有优势。Objective To compare the differences in dosimetric parameter between sequential boost intensity-modulated radiotherapy（ SB-IMRT） with simultaneously integrated boost intensity-modulated radiotherapy（ SIB-IMRT） for midpiece esophageal carcinoma.Methods Ten patients with midpiece esophageal carcinoma were seleCTed and treated with（ SB-IMRT and SIB-IMRT）. In SB plan the planned target area（ PTV） was given 50 Gy/25 F,and then the gross tumor volume（ GTV） had an extra boost of 10 Gy/5 F. The PTV was given 50 Gy/28 F and simultaneously the GTV was given 60 Gy/28 F in SIB plan. The differences in dosimetric parameter between SB-IMRT and SIB-IMRT were compared by using paired-samples t test. Results The conformal index（ CI） of SIB-IMRT（ 0. 59 ±0. 30） was superior to that of SB-IMRT（ 0. 59 ± 0. 30）（ P = 0. 000）,but the difference in homogeneity index（ HI） was not statistically significant（ P = 0. 105）. The V（20）,V（30） and mean lung dose（ MLD） of the right lung,MLD of the left lung,and V（50） of the heart in SIB-IMRT plan were lower than those in SB-IMRT plan（ P = 0. 012; P = 0. 007; P = 0. 002; P = 0. 001 and P = 0. 003,respeCTively）,but the V（20）,V（30） of the left lung and the maximum dose of spinal cord were not significantly different（ P = 0. 053; P = 0. 134 and P =0. 998,respeCTively）. Conclusions On the condition of the same amount of physical dose,compared with SB-IMRT,the SIB-IMRT has better conformability and can efficiently reduce the risk of partial damage to organs especially for the lung and the heart.

关 键 词：食管肿瘤 放射疗法 调强适形 放射剂量分次 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]