偏中心调强布野对中枢神经系统儿童放射治疗首次摆位的影响  

Effect of distribution field of off-center IMRT on initial positioning of radiotherapy on central nervous system of children

作　　者：吴伟 黄庆荣 周巧敏 罗日顺 邓官华 张平 戴鹏 罗龙辉 蔡林波 WU Wei;HUAGN Qing-rong;ZHOU Qiao-min(Center of Comprehensive Therapy of Cancer,Guangdong 999 Brain Hospital,Guangzhou 510510,China)

机构地区：[1]广东三九脑科医院肿瘤综合治疗中心,广东广州510510

出　　处：《中国医学装备》2020年第12期56-59,共4页China Medical Equipment

摘　　要：目的:探讨偏中心调强布野技术在中枢神经系统儿童放射治疗中的临床应用价值。方法:选取医院收治的102例行全中枢调强放射治疗(IMRT)患儿,根据IMRT治疗中布野方法的不同,将其分为观察组(50例)和对照组(52例);观察组行偏中心调强布野,对照组行等中心调强布野。记录并分析两组患儿2%、98%靶区体积对应的受照剂量(D2、D98)和平均剂量(Dmean)、靶区剂量适形度指数(CI)和均匀度指数(HI);分析拍片验证时间、左右(X轴)方向、头脚(Y轴)方向及腹背(Z轴)方向的摆位误差。结果:观察组与对照组的剂量参数D_2、D_(98)、D_(mean)、CI和HI以及在X和Y方向摆位误差比较,差异均无统计学意义,而在拍片验证时间和Z轴方向摆位误差比较,差异均有统计学意义(Z=-5.375,Z=-2.727;P<0.05)。结论:偏中心调强布野能够有效缩短全中枢儿童患者首次拍片验证时间和减小Z轴方向摆位误差,可有效改善儿童患者舒适度和提高放射治疗精度。Objective:To explore the application value of off-center intensity modulation radiotherapy(IMRT)technique on central nervous system of children.Methods:102 pediatric patient who underwent IMRT on whole central nervous in hospital were selected,and all of them were divided into observation group(50 cases)and control group(52 cases)according to different mode of distribution field of IMRT.The observation group underwent distribution field of off-center IMRT while the control group underwent that of isocenter IMRT.The exposure doses that corresponding to 2%and 98%target region volume(D2 and D98),the mean dose(Dmean),conformity index(CI)and homogeneity index(HI)of target region volume of two groups were recorded and analyzed.And then,the verification time of shooting,the positioning errors of left-right direction(X),head-foot direction(Y)and abdomen-back direction(Y)were further analyzed.Results:The differences of D2,D98,Dmean,CI,HI and the positioning errors on X and Y direction between observation group and control group were no significant.While the differences of verification time of shooting and positioning error on Z direction between them were significant(Z=-5.375,Z=-2.727,P<0.05).Conclusion:The distribution field of off-center IMRT can effectively shorten the verification time of initial shooting and reduce positioning error on Z direction for whole central nervous of pediatric patient,and it can effectively improve the comfort level of pediatric patient and enhance the precision of radiotherapy.

关 键 词：放射治疗 全中枢神经系统 调强放射治疗(IMRT) 首次摆位 直线加速器 

分 类 号：R816.92[医药卫生—放射医学]