非共面射野对上胸部食管癌调强放疗计划的影响  

Effect of Non-coplanar Field on Intensity-modulated Radiotherapy Plan for Upper Thoracic Esophageal Cancer

作　　者：刘俊[1] 石丽婉[1] LIU Jun;SHI Liwan(Department of Radiation Oncology,First Affiliated Hospital of Xiamen University,Xiamen Fujian 361001,China)

机构地区：[1]厦门大学附属第一医院肿瘤放疗科

出　　处：《中国卫生标准管理》2019年第23期29-31,共3页China Health Standard Management

摘　　要：目的研究引入非共面射野对上胸部食管癌调强放疗的剂量学影响。方法选取2016年1月-2018年1月我院收治的上胸部食管癌放疗患者25例,添加一个治疗床90度、机架角330度的非共面射野,制定调强放疗计划并与普通的调强计划进行对比,比较靶区的覆盖情况和肺、心脏、脊髓等的剂量学差异,并对计划执行效率进行对比。结果引入非共面射野后靶区的均匀性有一定改善,全肺V5平均降低1.29%(P<0.001),V20平均下降1.54%(P<0.001)。心脏V40下降(P=0.015),平均值下降(P=0.012),治疗跳数增加(P<0.001)。结论食管癌放疗计划引入非共面射野能明显降低肺的剂量,从而降低放射性肺炎发生的风险,也能减少心脏的毒性,但是非共面计划会稍微增加治疗时间。Objective To study the dosimetric effects of non-coplanar field on intensity-modulated radiotherapy for upper thoracic esophageal cancer.Methods 25 patients with upper thoracic esophageal cancer treated in our hospital from January 2016 to January 2018 were selected,add a non-coplanar field with a couch of 90 degrees and a angle of 330 degrees.Develop a plan for intensity-modulated radiation therapy and compare it with the general intensity-modulation plan,the dose distribution of the target area and the dosimetric differences of the lung,heart,spinal cord were compared.The treatment efficiency of the plan was also compared.Results Non-coplanar fields improved the uniformity of the target area,it decreased V5 and V20 of total lung by 1.29%and 1.54%average(P<0.001).It had lower V40(P=0.015)and the mean dose(P=0.012)of heart.But on the other hand,the number of treatment hop count increased(P<0.001).Conclusion The introduction of non-coplanar radiation in the esophageal cancer radiotherapy plan can significantly reduce the dose of the lungs,thereby reducing the risk of radiation pneumonitis and reducing the toxicity of the heart.But the plan of non-coplanar will increase treatment time slightly.

关 键 词：上胸部食管癌 调强放疗 非共面射野 靶区剂量 危及器官剂量 治疗效率 

分 类 号：R735[医药卫生—肿瘤]