全脑全脊髓放疗中静态调强和容积调强的剂量学对比  

Dosimetric Comparison of Volume Modulated Arc Therapy and(Step and Shoot)Intensity Modulated Radiotherapy in Craniospinal Irradiation

作　　者：朱俐颖 胡小洋 孙磊[1] 汪洋[1,2] Zhu Liying;Hu Xiaoyang;Sun Lei;Wang Yang(Department of Radiation Oncology,Shanghai Huashan Hospital,Shanghai,200235;Department of Radiation Oncology,Shanghai GAMMA Knife Hospital,Shanghai,200235)

机构地区：[1]复旦大学附属华山医院放射治疗中心,上海200235 [2]上海伽玛医院放疗科,上海200235

出　　处：《辐射防护通讯》2020年第3期15-18,共4页Radiation Protection Bulletin

摘　　要：回顾性选取2019年在我院放疗中心接受全脑全脊髓照射(CSI)的病人20例,勾画靶区和危及器官(OAR)后,传输至Oncentra 4.1治疗计划系统,对全脑全脊髓放疗采用静态调强(ss-IMRT)和容积调强(VMAT)两种放疗技术进行计划,分别计算两种技术的适形指数(CI)、均匀指数(HI)、107%处方剂量线所包含的靶区体积(V107)、靶区内最大剂量点剂量值(Dmax)、危及器官受量、正常组织(NT)受量、机器跳数和治疗时间并进行比较,比较两种调强方法的剂量学差异。结果表明,采用VMAT技术,靶区覆盖度、CI、HI、V107、Dmax、OAR受照量等参数优于ss-IMRT技术,治疗时间和机器跳数也明显减少。但靶区外正常组织(NT)低剂量的辐射区域增大。说明在CSI中,VAMT优于ss-IMRT具有优势,但接受CSI患者大多是儿童,低剂量的辐射区域是否增加不良反应及其对临床影响有待于进一步研究。A retrospective study was conducted on 20 patients who received craniospinal irradiation in our hospital’s radiotherapy center in 2019.After sketching the target area and organs at risk(OAR),the scanning CT images were transmitted to Treatment Planning System(TPS),Oncentra 4.A clinically feasible radiotherapy plan was designed for ss-IMRT and VMAT.Conformality index(CI),homogeneity index(HI),V107,maximum dose(Dmax),organ at risk(OAR)dose volume level,monitor units and treatment time were used to analyze in these groups.In VAMT group CI,HI,V107,Dmax and OAR of target areas were significantly superior to ss-IMRT group,the organ at risk dose volume level in the VAMT group was lower than the ss-IMRT groups.The VAMT group also had the less monitor units and the shorter treatment time.Dose radiation is extended and the overall dose is increased.Illustration VAMT has advantages over ss-IMRT in whole brain and spinal cord radiotherapy,but most of the patients undergoing CSI irradiation are children.Whether the increase of low dose radiation area brings adverse reactions and its clinical effects need to be further observed and studied.

关 键 词：全脑全脊髓放疗 静态调强 容积调强 

分 类 号：R144[医药卫生—公共卫生与预防医学]