同中心分段布野技术在食管癌全段调强放疗计划设计中的应用研究  

Segmented Field Distribution with One Isocenter in the Intensity-modulated Radiotherapy of Long Esophageal Cancer

作　　者：余文亮[1] 吴建平 杨钦杰 童集思 YU Wenliang;WU Jianping;YANG Qinjie(Quzhou People's Hospital,Quzhou,324000)

机构地区：[1]浙江省衢州市人民医院,324000

出　　处：《实用癌症杂志》2021年第5期775-778,共4页The Practical Journal of Cancer

摘　　要：目的研究全段食管癌放射治疗中使用同中心分段5野IMRT技术相比采用全段5野IMRT技术的优势。方法分别为接受调强放射治疗的30例全段食管癌患者使用Elekta XIO 4.64计划系统设计同中心分段5野调强计划和全段5野调强计划,计划设计中要求95%的PGTV、PTV体积达到处方剂量。比较两种治疗计划靶区和危及器官的剂量学差异。结果同中心分段5野调强计划在对其他危及器官的剂量和靶区CI、HI影响并不大的同时,能明显降低全肺的V5和全肺的平均剂量。结论在全段食管癌放疗计划设计时,与常规的全段5野交叉布野相比,同中心分段5野调强治疗计划可以有效地降低全肺的V5和平均照射剂量,从而减少放射性肺炎的发生概率,提高全段食管癌患者放疗后的生存质量。Objective To investigate the dosimetric advantage of one isocenter intensity-modulated radiotherapy(IMRT)with segmented field distribution in comparison with unsegmented field distribution in the treatment of esophageal cancer with long target volume.Methods 30 esophageal cancer patients with long target volumes were enrolled in this study.One-isocenter IMRT plans with both segmented and unsegmented field distributions were generated with Elekta XIO 4.64.A target coverage of 95%isodose line on planning gross target volume(PGTV)and planning target volume(PTV)was required during planning optimization.Dosimetric differences on target volumes and organ at risks(OARs)were compared.Results There had no significant difference in the conformal index(CI)and homogeneity index(HI)of target volumes,as well as the OAR dosimetric distributions was observed.However,IMRT with segmented field distribution significantly decreases the V5 and mean lung dose for lung.Conclusion One-isocenter IMRT with segmented field distribution can decrease the irradiation dose to lung to decrease the incidence of radiation induced pneumonitis,so as to improve the quality of life for patients with esophageal cancer after radiotherapy.

关 键 词：食管癌 IMRT技术 同中心分段 

分 类 号：R735.1[医药卫生—肿瘤]