高分级脑胶质瘤4种同步加量调强放射治疗的剂量学分析  

Dosimetric analysis of 4 types of simultaneous integrated boost radiotherapy for high-grade glioma

作　　者：郭飞宝[1] GUO Feibao(Department of Radiotherapy,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院放疗科

出　　处：《中国医学物理学杂志》2019年第12期1396-1399,共4页Chinese Journal of Medical Physics

基　　金：福建省高校产学合作项目(2019Y4005)

摘　　要：目的:探讨高分级脑胶质瘤术后调强放疗中采用二、三级同步加量容积调强(VMAT)及静态调强(IMRT)放射治疗技术的剂量学特点。方法:随机选取脑胶质瘤术后患者21例,分别进行二、三级同步加量的IMRT、VMAT设计。利用剂量体积直方图(DVH)以及横断面的等剂量曲线等评价4种计划对靶区和正常组织的照射剂量,采用配对t检验比较4种计划不同参数的剂量学差异。结果:VMAT计划的CI相对于IMRT较好。二、三级同步加量IMRT相比较,其正常脑组织的实际受量除V10外均无统计学意义;二、三级同步加量VMAT相比较,其正常脑组织的实际受量均无统计学意义。肿瘤附近的正常脑组织受量相对复杂,大体上除V10和部分V20、V30和Dmean外均无统计学意义。VMAT计划的机器跳数相对于IMRT无统计学意义。结论:脑胶质瘤术后放疗中VMAT技术较IMRT技术CI更好,而三级同步加量调强放疗技术相对于二级同步加量调强放疗技术在没有增加危及器官受量以及正常脑组织受量的情况下,可以较大幅度地增加肿瘤靶区的处方剂量,对脑胶质瘤患者有着重要的应用价值。Objective To investigate the dosimetric characteristics of the two-and three-stage simultaneous integrated boost methods for high-grade glioma using volumetric modulated arc therapy(VMAT)and static intensity-modulated radiotherapy(IMRT).Methods Four postoperative radiotherapy plans were designed for 21 randomly selected glioma patients,and the plans included the two-and three-stage simultaneous integrated boost VMAT(VMAT2 and VMAT3)as well as the two-and three-stage simultaneous integrated boost static IMRT(IMRT2 and IMRT3).Dose-volume histogram and cross-sectional isodose curve were used to evaluate the doses to target areas and normal tissues;and paired t-test was used to compare dosimetric differences among 4 plans.Results The CI of VMAT was better than that of IMRT.There was no significant difference between IMRT2 and IMRT3 in the dosimetric parameters of all brain except for V10;and the differences in the dosimetric parameters of all brain between VMAT2 and VMAT3 were trivial,without statistical significance.No statistical difference was found in the most of the dosimetric parameters of normal brain tissues near the tumor except for V10 and the V20,V30 and Dmean of some planning target rings.Moreover,the machine units were similar in VMAT and IMRT,without statistical differences.Conclusion As a postoperative radiotherapy for glioma,VMAT achieved a higher conformity index than IMRT.Compared with the two-stage simultaneous integrated boost radiotherapy,the three-stage simultaneous integrated boost radiotherapy for glioma can significantly increase the prescription dose to target areas while without increasing doses to organs-at-risk and brain tissues,having important application value in the treatment of glioma.

关 键 词：脑胶质瘤 容积旋转调强 静态调强 放疗剂量 同步加量 

分 类 号：R815[医药卫生—放射医学] R739.41[医药卫生—临床医学]