调强补偿高剂量率后装两种计划方案的剂量学比较  

A dosimetric comparison between two plans in IGRT boost HDR brachytherapy

作　　者：林琳[1] Lin Lin(Radiation Therapy Room,Yantaishan Hospital,Yantai 264025,China)

机构地区：[1]烟台市烟台山医院放疗室,264025

出　　处：《国际医药卫生导报》2020年第12期1720-1723,共4页International Medicine and Health Guidance News

摘　　要：目的比较调强补偿高剂量率后装中两种计划方案的剂量差异,为更好地制定调强补偿高剂量率计划提供依据。方法选取2014年7月至2015年12月本院已接受调强补偿高剂量率后装治疗的根治性宫颈癌患者20例,腔内照射计划相同,调强补偿计划分为两种,第一种不考虑腔内照射剂量对调强补偿计划剂量优化的影响,第二种基于腔内照射剂量进行调强补偿计划剂量优化,这两种调强补偿计划与腔内照射计划相加后分别称为A方案和B方案,利用SPSS19.0统计分析A,B两种方案高危靶区(high risk clinical target volume,HRCTV)的D90%、适形度指数(conformal index,CI),膀胱、直肠、小肠的D2cc,评估两种方案的差异。结果在HRCTV剂量分布都满足要求的情况下,B方案HRCTV的CI平均值比A方案提高,并且B方案中膀胱、直肠的D2cc平均值比A方案分别降低了43.19 cGy、35.94 cGy,差异均有统计学意义(均P<0.05);两种方案小肠D2cc比较,差异无统计学意义(P>0.05),但B方案小肠D2cc的平均值比A方案降低28.64 cGy。结论调强补偿高剂量率后装中基于腔内照射剂量进行调强补偿计划剂量优化这一方案能有效提高靶区剂量适形度指数,并能显著降低膀胱直肠的D2cc。Objectives To have better plans for IGRT boost HDR brachytherapy technique,a dosimetric comparison was made between two plans in image guided radiation therapy(IGRT)boost high dose rate(HDR)brachytherapy.Methods 20 cases were randomly selected from the cervical cancer patients who were treated by IGRT boost HDR brachytherapy in our hospital from July,2014 to December,2015.These cases’intracavitary brachytherapy(ICBT)plans were the same.The IGRT plans were divided into two kinds.Plan A had no consideration of ICBT dose while doing IGRT dose optimization.The IGRT dose optimization of plan B was based on the ICBT dose.SPSS19.0 was used to analyze D90%and conformal index(CI)of high risk clinical target volume(HRCTV)as well as the D2cc of bladder,rectum,and sigmoid.Results Plan B provided relatively higher HRCTVCI than plan A(P<0.05).Moreover,the D2cc of bladder and rectum were lower in plan B than in plan A(those in plan B decrease by 43.19 cGy and 35.94cGy,respectively;both P<0.05).There was no statistical difference in the D2cc of sigmoid between the two methods(P>0.05).for,however,the mean value of plan B was reduced by 28.64 cGy as compared with that of plan A.Conclusions For IGRT boost HDR brachytherapy technique,plan B can improve targeted CI and decrease the D2cc of bladder and rectum significantly.

关 键 词：后装 图像引导放射治疗 宫颈癌 剂量 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]