基于螺旋断层放射治疗技术的全骨髓照射治疗计划设计质量评估方法研究  

A preliminary study for the quality assessment method of treatment plan design of total marrow irradiation based on tomotherapy technique

作　　者：朱峰[1] 楼晓[2] 常冬姝[1] 吴伟章[1] 王颖杰[1] ZHU Feng;LOU Xiao;CHANG Dong-shu(Department of Radiation Oncology,Air Force General Hospital of PLA,Beijing 100142,China.)

机构地区：[1]空军总医院肿瘤放疗科,北京100142 [2]解放军第307医院造血干细胞移植科,北京100071

出　　处：《中国医学装备》2018年第12期48-52,共5页China Medical Equipment

基　　金：首都市民健康项目培育(Z15110000391511)"螺旋断层放疗技术用于全骨髓照射治疗中的前瞻性探索研究"

摘　　要：目的:探讨采用螺旋断层放射治疗技术全骨髓照射治疗(TMI)计划质量评估的新方法。方法:回顾性分析空军总医院肿瘤放疗科接受TMI治疗的18例患者的治疗计划结果,统计各部位靶区的适形度指数(CI)、均匀度指数(HI)、靶区剂量D_(90)、D_(10)、D_(mean)以及正常组织D_(50)等参数。计算正常组织质量指数(NQI)、靶区质量指数(TQI)和计划质量指数(PQI),并进行Pearson相关性分析。结果:多数正常组织剂量D_(50)均低于6 Gy,如大脑、双肺和肝脏分别为(6.0±0.69)Gy、(5.35±0.47)Gy和(4.82±0.88)Gy。头颈部靶区剂量分布最差,胸腹部及四肢趋中,盆腔部最优。相关性分析TQI与修正NQI呈显著负相关(r=-0.512,P<0.05);PQI与TQI呈显著正相关(r=0.517,P<0.05)。PQI值最高(0.941)的患者NQI值最低(0.860),而TQI值处于平均水平之上(0.893);PQI值最低(0.821)的患者NQI值处于平均水平之下(0.965),TQI值最低(0.811)。结论:所建立的评估指数PQI,能够均衡的综合容纳正常组织剂量限制结果和靶区剂量覆盖结果,并获得一个可以量化比较治疗计划优劣的指数,但进一步研究时需结合临床分析应用。Objective:To investigate a new method of quality assessment of total marrow irradiation(TMI)plan that adopted tomotherapy technique.Methods:The results of treatment plans of 18 patients who received the TMI were implemented retrospective analysis.And the conformity index(CI),homogeneity index(HI),D90,D10,Dmean and D50 of normal tissue in each target area were analyzed as statistic method.Besides,the quality index(NQI),target quality index(TQI)and plan quality index(PQI)of normal-tissue were calculated,and the Pearson relevant analysis were implemented.Results:The D50 of most of the normal tissue were less than 6Gy,such as brain(6.0±0.69Gy),total lung(5.35±0.47Gy)and liver(4.82±0.88Gy).For dose distribution of different target area,the area of head and neck was worst,and thorax,abdomen and limbs were middle,and the best was in pelvic cavity.Correlation analysis indicated that TQI was significant negative correlation with corrected NQI(r=0.512,P<0.05)and PQI was significant positive correlation with TQI(r=0.517,P<0.05).The patient with highest PQI(0.941)had the lowest NQI(0.860)and his TQI was above the average level(0.893),while the NQI value of one with lowest PQI(0.821)was under the average level(0.965)and his TQI was the lowest(0.811).Conclusion:The assessment index,PQI,can uniformly and comprehensively contain limitation results of normal tissue dose and coverage results of target area dose,and it can obtain an index that can be quantified and be compared with the advantage and disadvantage of treatment plan.While in further research,it need combine with clinical analysis so as to be used in practice.

关 键 词：全骨髓照射 计划质量指数 螺旋断层放射治疗 剂量分析 

分 类 号：R816.8[医药卫生—放射医学]