对比剂对模拟定位CT辅助Monaco-TPS制定肺癌患者动态调强放射治疗剂量的影响  

The effect of contrast agent on formulating dosage of dynamic IMRT of patients with lung cancer by simulated positioning CT auxiliary Monaco-TPS

作　　者：宫尚明 梅长文 王玮 邵尚敏 解华 GONG Shang-ming;MEI Chang-wen;WANG Wei(Department of Radiotherapy,The People’s Hospital of Xuancheng City,Xuancheng 242000,China;不详)

机构地区：[1]宣城市人民医院放疗科,安徽宣城242000

出　　处：《中国医学装备》2021年第5期9-12,共4页China Medical Equipment

基　　金：白求恩医学科学研究基金(B19059ET)“安罗替尼胶囊联合长春润滨软胶囊治疗晚期非小细胞的前瞻单臂开放性临床研究”。

摘　　要：目的:研究对比剂对模拟定位CT辅助Monaco-放射治疗计划系统(TPS)制定肺癌患者动态调强放射治疗剂量的影响。方法:选取医院收治的80例肺癌患者,CT模拟定位均行增强扫描,对比剂为碘海醇,分别采用Monaco-TPS设计计划A和计划B两种调强放射治疗(IMRT)计划:计划A为改变大血管内对比剂电子密度(80例患者);计划B为不改变大血管内对比剂电子密度(80例患者)。分析对比两种放射治疗计划的机器跳数、靶区剂量学指标、适形度指数(CI)、均匀性指数(HI)和危及器官(OAR)剂量学指标。结果:两种计划的单次机器跳数和靶区的CI、HI、95%的靶区体积所得到的95%体积的剂量(D_(95%))、最大剂量(D_(max))以及平均剂量(D_(mean))的差异均无统计学意义。计划A中患者左肺、右肺受5 Gy剂量照射的体积百分比(V_(5))、受20 Gy剂量照射的体积百分比(V_(20))及D_(mean)比计划B低,两种计划中右肺V_(5)的比较,差异有统计学意义(t=-1.801,P<0.05),左肺的V_(5)的差异亦有统计学意义(t=-2.201,P<0.05),双肺V_(20)和D_(mean)的差异均有统计学意义(t=-2.379,t=-2.268;P<0.05)。结论:对于定位时使用对比剂的肺癌患者,设计动态调强放射治疗计划时,改变增强CT图像中大血管内对比剂的电子密度,能降低OAR受照剂量。Objective:To study the effects of contrast agent on formulating dosage of dynamic intensity modulated radiation therapy(IMRT)of patients with lung cancer by simulated positioning computed tomography(CT)auxiliary Monaco-therapy planning system(TPS).Methods:80 patients with lung cancer were selected,and CT simulated positioning underwent the enhanced scanning,and the contrast agent was iodohydrin.And Monaco-TPS was adopted to respectively design two kinds of IMRT plan(Plan A and Plan B).Plan A changed the electron density of contrast agent within great vessels(80 cases),and Plan B didn’t change the electron density of that within great vessels(80 cases).And the machine units and dosimetry indicators of target region included conformity index(CI),homogeneity index(HI)and organ-at-risk(OAR)between the two kinds of radiation therapy were analyzed and compared.Results:There were no significant differences in single machine unit,CI,HI,the dose of 95%volume that obtained from 95%target region volume(D_(95%)),maximum dose(D_(max))and mean dose(D_(mean))between the two groups.V_(5),V_(20) and D_(mean) of the left and right lung in Plan A were lower than those in Plan B,and the difference of volume percentage(V_(5))of the right lung that received the radiation of Gy 5 dose between the two Plans was significant(t=-1.801,P<0.05).And the difference of the V_(5) of left lung between the two groups also was significant(t=-2.201,P<0.05).The differences of volume percentage(V_(20))and D_(mean) of whole lung received radiation of 20 Gy dose between two Plans were significant(t=-2.379,t=-2.268,P<0.05),respectively.Conclusion:For patients with lung cancer who use contrast agents for positioning,the change of electron density of contrast agent within great vessels in enhanced CT image can reduce the OAR exposure dose when the dynamic IMRT is designed.

关 键 词：对比剂 模拟定位CT 放射治疗计划系统(Monaco-TPS) 肺癌 动态调强放射治疗 剂量 

分 类 号：R734.2[医药卫生—肿瘤]