固定铅门技术应用于胸中段食管癌调强放疗的剂量学研究  

Dosimetric study of fixed-jaw technique in intensity-modulated radiotherapy for middle thoracic esophageal carcinoma

作　　者：宋威[1] 鹿红[1] 马珺[1] 赵迪[1] 刘婕 于大海[1] 张碧云[1] SONG Wei;LU Hong;MA Jun;ZHAO Di;LIU Jie;YU Dahai;ZHANG Biyun(Department of Radiation Oncology,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院放疗科

出　　处：《中国医学物理学杂志》2020年第2期159-163,共5页Chinese Journal of Medical Physics

基　　金：国家自然科学基金（81703758）;江苏省中医院院级课题（Y18019,Y2019CX26）

摘　　要：目的:探讨固定铅门调强计划(fj-IMRT)相对于常规分野调强计划(sf-IMRT)在胸中段食管癌放疗中的潜在剂量学优势。方法:选择10例接受根治性放疗的胸中段食管癌患者,分别制定sf-IMRT和fj-IMRT计划,统计靶区适形度指数、均匀性指数、靶区和危及器官的剂量体积参数、总射野数和机器跳数,各指标差异采用配对t检验。结果:sf-IMRT计划靶区D2%低于fj-IMRT计划(P=0.025)。双肺平均剂量(Dmean)、V5、V10、V20,左肺Dmean、V5、V10、V20、V30、V40,右肺Dmean、V5、V10,心脏Dmean和V40,靶区外身体Dmean、V5、V10、V20有显著差异(P<0.05),fj-IMRT优于sf-IMRT计划。两计划射野总数相同,fj-IMRT计划和sf-IMRT计划机器跳数分别为(1081.98±241.32)MU和(997.12±209.73)MU,sf-IMRT计划显著低于fj-IMRT计划(P=0.013)。结论:对于胸中段食管癌,fj-IMRT相较sf-IMRT能够显著降低肺、心脏和全身的低剂量照射,同时保证相似的靶区剂量覆盖和治疗实施效率。Objective To investigate the potential dosimetric benefits of fixed-jaw intensity-modulated radiotherapy(fj-IMRT)plans over conventional split-field IMRT(sf-IMRT)plans for middle thoracic esophageal carcinoma.Methods Both fj-IMRT and sf-IMRT plans were designed for selected 10 patients receiving radical radiotherapy for middle thoracic esophageal carcinoma.The conformity index and homogeneity index of target areas,the dose-volume parameters of target areas and organs-at-risk,the total number of fields and monitor units were calculated and analyzed using paired t-test.Results Compared with fj-IMRT plans,sf-IMRT plans had a lower target D2%(P=0.025).The mean dose(Dmean),V5,V10 and V20 of the lungs,the Dmean,V5,V10,V20,V30 and V40 of the left lung,the Dmean,V5 and V10 of the right lung,the Dmeanand V40 of the heart,and the Dmean,V5,V10 and V20 of the body volume minus PTV(body-PTV)in fj-IMRT plans were significantly lower than those in sf-IMRT plans,with statistical differences(P<0.05).The two plans had the same number of fields,and the monitor units in sf-IMRT plans were lower than those in fj-IMRT plans[(997.12±209.73)MU vs(1081.98±241.32)MU,P=0.013].Conclusion For middle thoracic esophageal carcinoma,fj-IMRT plans significantly reduced the low dose exposure of lungs,heart,and body-PTV compared with sf-IMRT plans,while maintaining the similar target coverage and plan delivery efficiency.

关 键 词：食管癌 固定铅门技术 调强放射治疗 剂量学 

分 类 号：R312[医药卫生—基础医学] R735.1