根治放射治疗宫颈癌患者中旋转容积调强与固定野静态调强的剂量  

Dose of Rotational Volume Modulation and Fixed Field Static Modulation in Radical Radiotherapy of Cervical Cancer Patients

作　　者：柏晗[1,2,3] 陈飞虎 李文辉 李岚[1,2] 朱思瑾[1,2] 刘旭红[1,2] Bai Han;Chen Feihu;Li Wenhui;Li Lan;Zhu Sijin;Liu Xuhong(Tumor Hospital of Yunnan Province,Kunming Yunnan 650118,China;The Third Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650118,China;Key Laboratory of Astroparticle Physics of Yunnan Province,Kunming Yunnan 650118,China)

机构地区：[1]云南省肿瘤医院,云南昆明650118 [2]昆明医科大学第三附属医院,云南昆明650118 [3]云南省粒子天体物理重点实验室,云南昆明650118

出　　处：《医疗装备》2019年第7期26-28,共3页Medical Equipment

摘　　要：目的比较根治放射治疗宫颈癌患者中旋转容积调强(VMAT)与固定野静态调强(s IMRT)的靶区剂量分布及危及器官体积剂量,为临床治疗选择更好的放射治疗技术提供参考。方法选取11例接受根治放射治疗的宫颈癌患者,在定位CT数据、靶区和危及器官完全一致的前提下,基于Pinnacle TPS为患者设计VMAT和sIMRT计划:VMAT_(Pinnacle)和sIMRTPinnacle,比较两种计划中靶区的剂量分布,适形指数(CI)、均匀性指数(HI)及危及器官的剂量体积,探讨两种计划的优劣,以及产生该种优劣的原因。结果分析PGTVnd和PTV的CI,VMAT_(Pinnacle)优于sIMRT_(Pinnacle),差异有统计学意义(P<0.05);分析PGTVnd的HI,VMAT_(Pinnacle)优于sIMRT_(Pinnacle),差异有统计学意义(P<0.05)。VMAT_(Pinnacle)和sIMRT_(Pinnacle)在直肠、膀胱的低剂量区,如V20,差异无统计学意义(P>0.05);在高剂量区域,VMAT_(Pinnacle)显现优于sIMRT_(Pinnacle)的趋势;在直肠的MeanDose上,VMAT_(Pinnacle)明显优于sIMRT_(Pinnacle),差异有统计学意义(P<0.05)。小肠和股骨头的剂量体积在两种计划中,除小肠的V10,差异均有统计学意义(P<0.05)。结论对于根治放射治疗宫颈癌患者,相较于sIMRT,选用VMAT_(Pinnacle)有潜在的剂量学优势。Objective To compare the target dose distribution and organ at risk volume dose of VMAT and sIMRT in radical radiotherapy for cervical cancer patients,and to provide a reference for clinical treatment selection of better radiotherapy technology.Methods Eleven patients with cervical cancer undergoing radical radiotherapy were selected.On the premise that the CT data,target area and endangering organs were identical,VMAT and sIMRT plans were designed for patients based on Pinnacle TPS:VMATPinnacle and sIMRTPinnacle,were used to compare the dose distribution in the target regions of the two schemes.The conformal index(CI),homogeneity index(HI)and the dose volume endangering the organ were discussed.The advantages and disadvantages of the two schemes were discussed and the reasons for the advantages and disadvantages of the two schemes were also discussed.Results According to the analysis of CI of PGTVnd and PTV,VMATPinnacle was superior to sIMRTPinnacle,and the difference was statistically significant(P<0.05).HI,VMATPinnacle was analyzed as superior to sIMRTPinnacle in PGTVnd,and the difference was statistically significant(P<0.05).There was no statistically significant difference between VMATPinnacle and sIMRTPinnacle in the low dose areas of the rectum and bladder,such as V20(P<0.05).In high-dose areas,VMATPinnacle appears to be superior to sIMRTPinnacle;On MeanDose in the rectum,VMATPinnacle was significantly superior to sIMRTPinnacle,and the difference was statistically significant(P<0.05).The dose-volume of the small intestine and the femoral head was statistically significant in both plans except for V10 in the small intestine(P<0.05).Conclusion For patients with cervical cancer treated with radical radiotherapy,the use of VMATPinnacle has a potential dosimetric advantage over sIMRT.

关 键 词：宫颈癌 固定野静态调强 旋转容积调强 剂量 

分 类 号：R730.55[医药卫生—肿瘤]