基于Varian 23EX直线加速器固定剂量率旋转调强应用于直肠癌放疗的研究分析  

Research analysis ofintensity-modulated arc therapyapplied in rectal cancer based on varian 23EX linear accelerator fixed dose rate

作　　者：郑士明 李玉成 史钟[3] 毛仙芝[1] 邵凯南[1] 张磊[1] ZHENG Shiming;LI Yucheng;SHI Zhong;MAO Xianzhi;SHAO Kainan;ZHANG Lei(Radiation Physics Room,Zhejiang Cancer Hospital,Hangzhou310022,China;Department of Radiotherapy,Zhejiang People's Hospital,Hangzhou310014,China;Department of Chemotherapy,Zhejiang Cancer Hospital,Hangzhou310022,China)

机构地区：[1]浙江省肿瘤医院放射物理室,浙江杭州310022 [2]浙江省人民医院放疗科,浙江杭州310014 [3]浙江省肿瘤医院化疗科,浙江杭州310022

出　　处：《中国现代医生》2019年第32期97-100,F0003,共5页China Modern Doctor

基　　金：国家自然科学基金（81602583）

摘　　要：目的通过对直肠癌患者分别设计固定剂量率旋转调强(FDR-IMAT)和可变剂量率容积弧形调强(RapidArc)计划进行剂量学分析,为采用旋转调强治疗直肠癌提供合适的治疗方式。方法选取2017年1~12月我院直肠癌患者10例。用Raystation计划系统分别对每个患者设计FDR-IMAT和RapidArc计划,采用相同的优化目标参数。结果两种计划均能满足临床要求,危及器官膀胱V40,小肠的Dmax、V35、V40无统计学差异(P>0.05);RapidArc计划相比FDR-IMAT计划,跳数减少,治疗时间减少,有统计学差异(P<0.05);靶区适形度指数(CI)无统计学差异(P>0.05)。靶区均匀性指数(HI)RapidArc好于FDR-IMAT,有统计学差异(P<0.05)。结论在直肠癌放疗方面,RapidArc技术相比FDR-IMAT技术,受照射的危及器官没有差异,但治疗跳数变少,治疗时间大大缩减,对于一些没有RapidArc技术的加速器可以选择使用FDR-IMAT进行放射治疗。Objective To design dosimetric analysis of patients with rectal cancer by fixed dose rate intensity-modulated arc therapy(FDR-IMAT) and variable dose rate volume tricintensity-modulated arc therapy(RapidArc), and to provide suitable treatment for rectal cancer treated withintensity-modulated arc therapy. Methods Ten patients with rectal cancer in our hospital from January to December 2017 were selected. The FDR-IMAT and RapidArc plans were designed for each patient, by the Raystation planning system and the same optimization target parameters. Results Both plans met the clinical requirements, endangering organ V40, Dmax, V35, V40 of the small intestine, there was no significant difference between the two plans(P>0.05). The hop count in the RapidArc plan was reduced, and the treatment time was reduced, compared to that of the FDR-IMAT plan. And there was a statistical difference(P<0.05). The target area conformity index(CI) had no statistical difference(P>0.05). Target area homogenous index(HI) of RapidArc was better than that of FDR-IMAT, with statistical difference(P<0.05). Conclusion In the radiotherapy for rectal cancer, there are no significant difference in the irradiated endangered organs between the RapidArc technique and the FDR-IMAT technique, but the number of treatment hops of RapidArcis reduced and the treatment time is greatly reduced. For some accelerators without RapidArc technology, FDR-IMAT can be selected for radiation therapy.

关 键 词：放射治疗 直肠癌 固定剂量率 容积旋转调强 

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