宫颈癌腹主动脉旁淋巴结转移固定野动态调强放疗与容积旋转调强放疗的剂量学比较  

Dosimetric study of dynamic intensity modulated radiotherapy and volumetric-modulated arc radiotherapy for cervical cancer with para-aortic lymph node metastasis

作　　者：李思妹 陆高平 邵盈[3] 曹小飞[1] Li Simei;Lu Gaoping;Shao Ying;Cao Xiaofei(Department of Oncology,Nansha Branch,Guangzhou First People's Hospital,Guangzhou 511457,China;Department of Neurology,Nansha Branch,Guangzhou First People's Hospital,Guangzhou 511457,China;Department of Tumor Radiotherapy,Huizhou Central People's Hospital,Huizhou 516008,China)

机构地区：[1]广州市第一人民医院南沙医院肿瘤科,511457 [2]广州市第一人民医院南沙医院神经内科,511457 [3]惠州市中心人民医院肿瘤放疗科,广东516008

出　　处：《国际医药卫生导报》2021年第16期2439-2442,共4页International Medicine and Health Guidance News

基　　金：广东省医学科学技术研究基金项目(C2019079)。

摘　　要：目的探讨腹主动脉旁淋巴结(PALN)转移的宫颈癌患者应用固定野动态调强(dIMRT)和容积旋转调强(VMAT)2种放疗技术计划的剂量学参数,为上述宫颈癌患者放疗技术选择提供参考依据。方法选取2015年8月至2019年5月在广州市第一人民医院南沙医院肿瘤科诊治的10例PALN转移的宫颈癌患者,其中4例为Ⅱb期,6例为Ⅲb期,中位年龄49岁,均进行CT扫描定位,对同一定位图像分别进行7野、9野dIMRT和双弧VMAT计划设计,比较7野、9野dIMRT和双弧VMAT 3组放疗计划的靶区剂量学参数、适形性指数(CI)和均匀性指数(HI)、危及器官(OAR)剂量学参数、放疗机器跳数(MU)的差异。结果7野、9野dIMRT和VMAT 3组放疗计划的靶区和OAR的剂量学参数、靶区CI[(0.87±0.02)比(0.86±0.01)比(0.85±0.03)]、靶区HI[(1.22±0.05)比(1.21±0.05)比(1.24±0.03)]和加速器MU[(856.76±76.32)比(912.45±100.02)比(996.00±259.27)]比较,差异均无统计学意义(均P>0.05)。结论对于宫颈癌伴PALN转移患者,7野、9野dIMRT和VMAT技术均可达到临床靶区和OAR的剂量保护要求,临床上均可采用。Objective To investigate the dose parameters of dynamic intensity modulated radiation therapy(dIMRT)and volumetric-modulated arc radiotherapy(VMAT)plans for cervical cancer patients with para-aortic lymph node(PALN)metastasis,thus to provide a reference for the choice of radiotherapy techniques for cervical cancer patients mentioned above.Methods Ten cervical cancer patients with PALN metastasis who were diagnosed and treated in the Department of Oncology,Nansha Branch,Guangzhou First People's Hospital from August 2015 to May 2019 were selected,including 4 cases of stageⅡb and 6 cases of stageⅢb,with a median age of 49 years old.The same CT images were designed with 7 field dIMRT,9 field dIMRT,and double arc VMAT,respectively.The differences of target dosimetry parameters,conformal index(CI),homogeneity index(HI),organ at risk(OAR)dosimetry parameters,and monitor unit(MU)were compared among the three groups(7 field dIMRT plan,9 field dIMRT plan,and VMAT plan).Results There were no statistically significant differences in the dosimetric parameters of target and OAR,CI[(0.87±0.02)vs.(0.86±0.01)vs.(0.85±0.03)]and HI[(1.22±0.05)vs.(1.21±0.05)vs.(1.24±0.03)]of target,and MU[(856.76±76.32)vs.(912.45±100.02)vs.(996.00±259.27)]of accelerator among the three groups(all P>0.05).Conclusions Both of the dIMRT and VMAT techniques can achieve the clinical dosimetric demands and protect the OARs of cervical cancer with PALN.Both plans can be used in the clinical practice.

关 键 词：宫颈癌 腹主动脉旁淋巴结转移 放射治疗 动态调强放疗 容积旋转调强放疗 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]