sIMRT与IMRT在胸段食管癌放疗靶区、危及器官剂量学及照射野参数中的差异分析  

Comparison of dosimetry and field parameters of sIMRT and IMRT in radiotherapy target area,dangerous organs of thoracic esophageal carcinoma

作　　者：成俊[1] 李伟[1] 周春[1] 徐金济[1] 姜玉铃 CHENG Jun;LI Wei;ZHOU Chun(Department of Radiation Oncology,The Third People′s Hospital of Nantong City,Jiangsu Province,Nantong 226000,China)

机构地区：[1]江苏省南通市第三人民医院放疗科,江苏南通226000

出　　处：《吉林医学》2021年第1期28-30,共3页Jilin Medical Journal

摘　　要：目的:比较简化调强适形放疗计划(sIMRT)与调强适形放疗计划(IMRT)在胸段食管癌放疗靶区、照射野参数及危及器官剂量学的差异。方法:选择46例接受sIMRT计划及IMRT计划的胸段食管癌患者作为研究对象,患者计划靶区剂量均为2 Gy/次。比较IMRT计划与sIMRT计划在放疗靶区、照射野参数及危及器官剂量学等方面的差异。结果:相比sIMRT计划,IMRT计划靶区剂量均匀度指数下降,适形度指数和≥60 Gy的计划靶体积百分比(V100)均升高,差异有统计学意义(P<0.01)。相比sIMRT计划,IMRT计划单次治疗子野数和机器跳数均显著增高,差异有统计学意义(P<0.05)。两种计划模式下心脏和肺剂量学参数的比较,差异无统计学意义(P>0.05),但相比sIMRT计划,IMRT计划脊髓最大剂量明显下降,差异有统计学意义(P<0.01)。结论:IMRT计划与sIMRT计划均可达到胸段食管癌患者放疗计划的基本要求,虽然IMRT计划靶区剂量分布均匀度及危及器官剂量学等方面较sIMRT计划更优,对脊髓的保护作用更强,但sIMRT计划具有更低的机器跳数和子野数,有利于减少机器损耗,亦能减少治疗时间。Objective To compare the dosimetric differences of simplified intensity-modulated radiation therapy(sIMRT)and intensity-modulated radiation therapy(IMRT)in target area,field parameters and organs at risk for thoracic esophageal cancer.Method 46 patients with thoracic esophageal cancer who received the sIMRT and IMRT plans were selected as the study subjects.The target dose of the patients was 2 Gy per time.The differences between IMRT and sIMRT in target area,field parameters and dosimetry of organs at risk were compared.Results Compared with the sIMRT plan,the dose uniformity index of the target area of the IMRT plan decreased,the conformity index and the percentage of planned target volume(≥60 Gy)increased(P<0.01).Compared with the sIMRT plan,the number of sub-fields and machine hops per treatment in the IMRT plan increased significantly(P<0.05).There was no significant difference in cardiac and pulmonary dosimetric parameters between the two schemes(P>0.05),but compared with the sIMRT scheme,the maximum dose of spinal cord in the IMRT scheme decreased significantly(P<0.01).Conclusion Both IMRT and sIMRT plans can meet the basic requirements of radiotherapy for thoracic esophageal cancer patients.Although IMRT plans have better target dose distribution uniformity and organ-threatening dosage than sIMRT plans,and have stronger spinal cord protection effect,the sIMRT plans have lower machine hops and sub-fields,which is beneficial to reduce machine wastage and treatment time.

关 键 词：调强适形放疗 简化调强适形放疗 食管癌 剂量学 

分 类 号：R735.1[医药卫生—肿瘤]