入射角度对中下段食管癌调强放射治疗的剂量学研究  

Dosimetric study of incident angles on IMRT of middle and lower esophageal carcinoma

作　　者：何赟[1] 李宇星 苏王辉 许琨[1] 马红兵[1] HE Yun;LI Yu-xing;SU Wang-hui(Department of Radiotherapy,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China.)

机构地区：[1]西安交通大学第二附属医院放疗科,陕西西安710004

出　　处：《中国医学装备》2021年第9期29-33,共5页China Medical Equipment

基　　金：陕西省重点研发计划(2021-SF-122)“食管鳞癌外泌体miR-155调控肿瘤微环境Treg细胞的作用及机制”。

摘　　要：目的:比较不同入射角度对中下段食管癌调强放射治疗(IMRT)计划的剂量学差异,为选取合适的放射治疗计划提供参考。方法:选取在医院接受IMRT的24例中下段食管癌患者,每例患者设计两组IMRT计划,入射角度均为5野,将不等分入射角度30°、135°、180°、225°和330°设为PlanA组,30°、125°、180°、235°和330°设为PlanB组,保证100%的等剂量线至少覆盖95%的计划靶区以及约束条件设置的罚分值尽量相等。比较两组放射治疗计划靶区和危及器官(OAR)的剂量学差异。结果:PlanB组的靶区适形度指数优于PlanA组,且差异有统计学意义(t=-8.08,P<0.05);但两组计划的均匀度指数的差异无统计学意义(t=-1.52,P>0.05)。两组计划双肺的剂量体积百分比(V_(20))的差异无统计学意义(t=1.99,P>0.05);PlanA组的双肺V_(5)、V_(10)及平均剂量(D_(mean))低于PlanB组,PlanA组的心脏V_(10)、V_(20)、V_(30)、V_(40)及D_(mean),脊髓及其外放的最大剂量(Dmax)高于PlanB组,且差异均有统计学意义(t=-30.69,t=-19.13,t=-16.94,t=3.82,t=2.64,t=9.59,t=8.38,t=10.45,t=8.34,t=8.21;P<0.05)。结论:在不损失放射治疗计划靶区的前提下,OAR多目标函数最优剂量解相互制约,临床中在满足剂量要求的前提下,结合食管癌患者自身身体条件来选择放射治疗计划,若患者双肺功能较差应选择PlanA,若患者心脏功能较差应选择PlanB。Objective:To compare the dosimetric differences of intensity-modulated radiotherapy(IMRT)of middle and lower esophageal carcinoma between different incident angles so as to provide reference for selecting appropriate radiotherapy treatment plan.Methods:24 patients with middle and lower esophageal carcinoma who received IMRT in hospital were selected.And two groups of IMRT plan were designed for each patient,and the incident angle of them were 5 fields.And the incident angles with non-divided from the middle(30°,135°,180°,225°and 330°)were set as Plan A group,and the incident angles included 30°,125°,180°,235°and 330°were set as Plan B group.These conditions ensured the 100%of isodose could cover 95%of planning target volume at least and constraint penalty point value of settlement of condition in equality in the greatest extent.And then the dosimetric differences of planning target volume and organ at risk(OAR)of radiotherapy between two groups were compared.Results:The conformal index of planning target volume of Plan B was significantly better than that of Plan A(t=-8.08,P<0.05),while the difference of uniformity index of the plans between two groups was no significant(t=-1.52,P>0.05).And the difference of the percent(V_(20))of dose volume of dual lungs between two groups was not significant(t=1.99,P>0.05).The V_(5),V_(10) and mean dose(D_(mean))of dual lungs of Plan A group were significantly lower than those of Plan B group,and the V_(10),V_(20),V_(30),V_(40) and D_(mean) of heart,and spinal cord and the max dose of extra spinal cord(Dmax)of Plan A group were significantly higher than those of Plan B group(t=-30.69,t=-19.13,t=-16.94,t=3.82,t=2.64,t=9.59,t=8.38,t=10.45,t=8.34,t=8.21,P<0.05).Conclusion:Under without losing the planning target volume of radiotherapy,the optimal dose solutions of multi-objective function of OAR is mutually restricted.Under the precondition of meeting the requirement of dose in clinical work,the self-physical qualifications of patients with esophagus carcinoma are combin

关 键 词：入射角度 调强放射治疗计划(IMRT) 中下段食管癌 剂量学 

分 类 号：R814.2[医药卫生—影像医学与核医学]