三维适形放疗和共面等分布野调强放疗计划在直肠癌治疗中的剂量学对比分析  

Dosimetric conparison of Three-dimensional anformal ladicthempy and Intensity mcdulatcd mditon Therapy in Rectalcaner

作　　者：张文博[1] 李萌 王立志[1] 轩玉宏[1] 薄飞[1] 宋冀[1] 宋云骏 ZHANG Wenbo;LI Meng;WANG Lizhi(The Central Hospital of Chengde,Hebei Chengde 067000,China)

机构地区：[1]河北省承德市中心医院放化疗中心

出　　处：《河北医学》2019年第7期1113-1116,共4页Hebei Medicine

基　　金：河北省承德市科技局科学技术研究与发展计划项目,(编号:201701A016)

摘　　要：目的:分析直肠癌病人术前放疗过程,3D-CRT(三维适形放疗)和IMRT(共面等分布野调强放疗),计划治疗靶区和临近敏感器官接受照射剂量的区别。方法:选我科(放化疗中心)在2017至2018年住院治疗的21名直肠癌病人,扫描患处CT影像,勾画治疗靶区和临近敏感器官,总照射剂量为5000CGy。先后设计3D-CRT和共面等分布野IMRT两组计划,评估HI(均匀度)、CI(适形度)、(Dmax)最大受照剂量、(Dmin)最小受照剂量、(Dmean)平均受照剂量和临近敏感器官的受照V(体积),得出结果并对比分析。结果:3D-CRT差于5F-IMRT、7F-IMRT、9F-IMRT的靶区适形度;对于受照射临近敏感器官的保护IMRT明显好于3D-CRT,P<0.05。结论:对于直肠癌病人的放疗,3D-CRT计划不论在适形度还是对临近敏感器官的保护两方面都明显差于IMRT计划,通过各方面的综合评估说明,5F比7F、9F都要好,不仅效率高且减轻病患的经济负担,临床上值得采用。Objective:To analyze the preoperative radiotherapy process in patients with rectal cancer,3D-CRT and IMRT plan to treat the target area and the proximity of sensitive organs to receive the difference in irradiation dose.Methods:Twenty-one rectal cancer patients hospitalized in our department(chemotherapy center)from 2017 to 2018.Scan the CT image of the affected area and delineate the target area and adjacent sensitive organs.The total dose is 5000CGy.Design 3D-CRT and coplanar and other wild IMRT plans to evaluate HI(uniformity),CI(conformity),(Dmax)maximum exposure dose,(Dmin)minimum exposure dose,(Dmean)average The exposure dose and the exposure V(volume)of the adjacent sensitive organs were obtained and compared.Results The 3D-CRT was worse than the target conformation of 5F-IMRT,7F-IMRT,and 9F-IMRT;the IMRT was significantly better than the 3D-CRT for the adjacent sensitive organs,P<0.05.Conclusion:For the radiotherapy of patients with rectal cancer,the 3D-CRT plan is significantly worse than the IMRT plan in both the conformality and the protection of the adjacent sensitive organs.According to the comprehensive evaluation of all aspects,5F is better than 7F and 9F.Not only is it efficient and reduces the economic burden of patients,it is clinically worthy of adoption.

关 键 词：直肠癌 三维适形 调强放疗 剂量 

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