直肠癌静态调强与容积旋转调强放疗剂量学研究  

Dosimetric Study of Step-and-Shoot Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Rectal Cancer

作　　者：赵培峰[1] 杨咏强[1] 周钢[1] 陈列松[1] 朱雅群[1] 田野[1] 陈子晗 Zhao Peifeng;Yang Yongqiang;Zhou Gang;Chen Liesong;Zhu Yaqun;Tian Ye;Chen Zihan(Second Affiliated Hospital of Soochow University,Institute of Radiotherapy & Oncology,Soochow University,Suzhou 215004,China;School of Public Health,Xuzhou Medical University,Xuzhou 221004,China)

机构地区：[1]苏州大学附属第二医院,苏州大学放射肿瘤治疗学研究所,江苏苏州215004 [2]徐州医科大学公共卫生学院,江苏徐州221004

出　　处：《北华大学学报（自然科学版）》2019年第4期481-484,共4页Journal of Beihua University（Natural Science）

基　　金：江苏省医学创新团队(CXDT-37);苏州市科技发展计划项目(SS201642);苏州市“科教兴卫”青年科技项目(KJXW2016010)

摘　　要：目的 比较直肠癌术后放疗中静态调强放疗(IMRT)和容积旋转调强放疗(VMAT)的剂量学差异,为临床治疗方法的选择提供参考.方法 对10例Ⅱ~Ⅲ期直肠癌术后放疗患者分别进行双弧VMAT和7野IMRT的计划设计,利用剂量体积直方图评价靶区剂量分布以及危及器官的照射剂量,并进行比较分析.结果 IMRT和VMAT治疗计划的治疗剂量均能满足临床要求.IMRT和VMAT计划的适形指数(CI)及均匀指数(HI)比较差异均无统计学意义.IMRT和VMAT计划的正常组织如小肠、膀胱、骨盆和股骨头的剂量均相似.IMRT和VMAT计划的平均机器跳数分别为581.80和960.37(P=0.001),相应的治疗时间分别为558s和170s(P=0.003).结论 直肠癌VMAT和IMRT计划均可满足患者临床要求,采用VMAT计划的患者治疗时间明显缩短,治疗效率明显提高.Objective To compare the dosimetric differences between static intensity modulated radiotherapy (IMRT) and volume rotation intensity modulated radiotherapy (VMAT) in postoperative radiotherapy for rectal cancer,and to provide references for the selection of clinical treatment methods.MethodTen patients with stage Ⅱ-Ⅲrectal cancer who underwent post-operative radiotherapy were given dual-arc VMAT and 7-field IMRT planning respectively.Dose volume histogram was used to evaluate the dose distribution in target area and the radiation dose of organs at risk. Results Both IMRT and VMAT treatment plans met the clinical requirements.There was no significant difference in CI and HI between IMRT and VMAT.The doses of IMRT and VMAT in normal tissues such as small intestine,bladder,pelvis and femoral head were similar.The average machine hops of IMRT and VMAT were 581.80 and 960.37 ( P =0.001),respectively,and the corresponding treatment time was 558 s and170 s ( P =0.003).Conclusion Both VMAT and IMRT plans for rectal cancer can meet the clinical requirements.The treatment time of patients with VMAT plans is significantly shortened and the treatment efficiency is significantly improved.

关 键 词：直肠肿瘤 放射疗法 容积调强 放射疗法 调强适形 剂量学 

分 类 号：R730.55[医药卫生—肿瘤] R735.37[医药卫生—临床医学]