肺癌脑转移全脑照射中不同调强放疗计划对保护海马的剂量学研究  

Dosimetric Study of Brain Metastases from Lung Cancer in the Whole Brain Irradiation of Different Intensity Modulated Radiation Therapy to Protect the Hippocampus

作　　者：褚俊峰[1] 张西志[2] 张先稳[2] 陈小军[1] 陈永东 孙新臣 李金凯 李军[2] CHU Junfeng;ZHANG Xizhi;ZHANG Xianwen;CHEN Xiaojun;CHEN Yongdong;SUN Xinchen;LI Jinkai;LI Jun(Department of Radiotherapy,Jiangdu People's Hospital,Yangzhou 225200,China;Department of Radiotherapy,Subei People's Hospital,Yangzhou 225001,China;Department of Radiotherapy,Yangzhou Hongquan Hospital,Yangzhou 225200,China;Department of Radiotherapy,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]江苏省扬州市江都人民医院放疗科,江苏扬州225200 [2]江苏省苏北人民医院放疗科,江苏扬州225001 [3]江苏省扬州市洪泉医院放疗科,江苏扬州225200 [4]南京医科大学第一附属医院放疗科,江苏南京210029

出　　处：《临床医学工程》2018年第11期1440-1442,共3页Clinical Medicine & Engineering

摘　　要：目的比较旋转容积调强(RapidArc)与固定野逆向动态调强(IMRT)在肺癌脑转移瘤患者的全脑照射中对海马保护的剂量学研究。方法针对我院6例肺癌脑转移瘤患者分别设计两种放疗计划, IMRT和RapidArc双弧旋转容积调强。在保证计划均满足临床要求前提下分别比较两种治疗计划的靶区剂量分布及适形度和均匀性指数、危及器官的受照剂量、机器跳数以及治疗时间,探讨其剂量学差异。结果两种治疗计划均可以满足临床治疗要求, RapidArc计划的靶区适形度、均匀性均优于IMRT调强放疗计划。RapidArc计划的海马、双侧眼球最大剂量Dmax均低于IMRT (P <0.05),危及器官的受照剂量结果总体优于IMRT。与IMRT相比, RapidArc计划的平均机器跳数减少67%; RapidArc计划的平均出束时间为150 s,明显短于IMRT计划的573 s。结论 RapidArc旋转容积调强计划的靶区剂量分布优于IMRT计划,能够更好地降低危及器官的受照剂量,同时可显著降低机器跳数和治疗时间。Objective To compare the dosimetry of RapidArc(volumetric modulated arc therapy,VMAT)and dynamic intensity-modulated radiation therapy(IMRT)to protect the hippocampus in the whole brain irradiation of patients with brain metastases from lung cancer.Methods 6 cases of patients with brain metastases from lung cancer in our hospital respectively received two kinds of radiotherapy treatment plans,IMRT and RapidArc.Under the precondition of guarantee scheme can satisfy the clinical requirements,the dose distribution and conformal degree of target area,uniformity index,irradiation dose of organs at risk,machine units and treatment time.The dosimetry difference was discussed.Results Both treatment plans could meet the requirements of clinical treatment.The conformal degree and uniformity of target area of RapidArc plan was better than that of IMRT plan.The maximum dose Dmax on hippocampus and lens of RapidArc plan were lower than those of IMRT plan(P<0.05),and the irradiation dose of organs at risk was superior to IMRT plan.Compared with IMRT,the average machine units had reduced by 67%.The average treatment time of RapidArc plan was 150 s,significantly shorter than 573 s of IMRT plan.Conclusions RapidArc plan has better dose distribution of target area compared with IMRT plan,can better reduce the irradiation dose of organs at risk,and significantly reduce the treatment time and machine units.

关 键 词：肺癌脑转移 全脑照射 调强放疗 旋转容积调强 海马 剂量学 

分 类 号：R734.2[医药卫生—肿瘤]