基于模型的肺部肿瘤内外两种放疗方案的肺受照物理剂量差异分析  

An analysis of the difference in lung dose between two radiotherapy regimens for lung tumor based a phantom

作　　者：杨波 YANG Bo(Department of Oncology,the Affiliated Hospital of Southwest Medical University,Luzhou 64600,Sichuan Prov-ince,China)

机构地区：[1]西南医科大学附属医院肿瘤科,四川泸州646000

出　　处：《西南医科大学学报》2021年第1期46-50,共5页Journal of Southwest Medical University

基　　金：四川省卫健委科研课题(18PJ202);四川省医学科研课题(S19007)。

摘　　要：目的:通过比较组织间近距离插植内照射与调强外照射之间的肺受照剂量V20和V30,分析对于晚期肺癌伴有纵膈淋巴节转移患者实施肿瘤靶区组织间近距离插植内照射加纵膈淋巴结调强外照射的方案来缓解肺受量限制的可行性。方法:在人形模体的CT图像上模拟勾画肺部肿瘤靶区和纵膈淋巴节靶区,分别针对各靶区制作组织间近距离插植放疗计划和调强放疗计划,针对纵膈淋巴节靶区做调强计划;分析肺V20和V30差异;分析V20之差与靶区体积的之间的关系。结果:在包含近距离插植放疗计划的方案中获得了肺V20和V30较低的结果,除了针对肺部相同体积大小靶区的两种方案V20参数差异不具有统计学意义(P>0.05)外,其他比较中的肺参数V20和V30差异具有统计学意义(P<0.05);两种方案中的肺V20和V30差值随靶区体积的增加而减少。结论:组织间近距离插植内照射加纵膈淋巴结调强外照射的方案在缓解肺受量的限制上具有一定的可行性,但其适应症在肿瘤体积大小上可能存在限制。Objective:To compare the percentages of lung volume receiving≥20 Gy(V20)and≥30 Gy(V30)between interstitial brachytherapy(ISBT)and intensity-modulated radiotherapy(IMRT)in advanced lung can⁃cer patients with mediastinal lymph node metastasis,and to investigate the feasibility of using ISBT for the lung tu⁃mor plus IMRT for mediastinal lymph nodes to reduce the lung dose.Methods:The target volumes of lung tumor and mediastinal lymph nodes were delineated on the CT images of a human phantom.The ISBT plan and IMRT plan were made for each target volume,and the IMRT plan was made for the mediastinal lymph node target volume.Com⁃parison of lung V20 and V30 was made.The relationship between V20 difference and the size of target volume was analyzed.Results:Lung V20 and V30 were lower in the regimen involving ISBT plan,and there were significant dif⁃ferences in lung V20 and V30 between the two regimens(P<0.05),except in lung V20 for the lung target volumes of the same size(P>0.05).The V20 and V30 differences of the two regimens decreased with the increase in the size of target volume.Conclusion:ISBT for the lung tumor plus IMRT for mediastinal lymph nodes is feasible to reduce the lung dose,and it may be limited by the tumor size.

关 键 词：组织间插植放疗 调强放疗 肺剂量 

分 类 号：R815.2[医药卫生—放射医学]