三种放疗技术在食管癌淋巴结预防性照射的剂量学比较  

Dosimetric Comparison of Three Radiotherapy Techniques in Prophylactic Irradiation for Lymph Nodes of Esophageal Cancer

作　　者：韩栋梁 易峰涛 葛强 葛宁 HAN Dongliang;YI Fengtao;GE Qiang;GE Ning(Department of Oncology,General Hospital of Central Theater Command of PLA,Wuhan Hubei 430070,China;Department of Radiology,Maternity and Child Healthcare Hospital of Hubei Province,Wuhan Hubei 430070,China)

机构地区：[1]中部战区总医院肿瘤科放疗病区,湖北武汉430070 [2]湖北省妇幼保健院放疗科,湖北武汉430070

出　　处：《中国医疗设备》2021年第12期58-61,共4页China Medical Devices

摘　　要：目的通过比较调强放疗(Intensity Modulated Radiation Therapy,IMRT)、共面容积旋转调强(Volumetric Modulated Arc Therapy,VMAT)和非共面VMAT技术在食管癌淋巴结预防性照射中的剂量学差异,探讨适于食管癌淋巴结预防照射的放射治疗方法。方法选取20例晚期不能手术拟行大范围淋巴结预防性照射的食管癌患者,分别制定7野IMRT调强计划、共面VMAT计划和非共面VMAT计划。比较三种计划的剂量学指标差异:靶区适形指数(Conformity Index,CI)、均匀性指数(Homogeneity Index,HI)以及危及器官受量(双肺Dmean、V5、V10、V20、V30,心脏的V30与V40,脊髓的最大剂量Dmax)。同时比较执行三种技术时的加速器总机器跳数和治疗时间。结果靶区HI、双肺V20,共面VMAT计划和非共面VMAT计划均优于IMRT计划;双肺V5,IMRT计划和非共面VMAT计划优于共面VMAT计划;双肺Dmean、V10,非共面VMAT计划优于其他两种计划。与VMAT相比,IMRT计划机器跳数最多,治疗时间最长。结论对于食管癌淋巴结预防性照射,非共面VMAT有明显的剂量学优势,而且与IMRT相比显著缩短治疗时间,值得推荐。Objective To explore the radiotherapy methods suitable for the prophylactic irradiation for lymph nodes of esophageal cancer by comparing dosimetric differences of intensity modulated radiation therapy(IMRT),coplanar and non-coplanar volumetric modulated arc therapy(VMAT).Methods Twenty patients with esophagus cancer who could not be operated at an advanced stage and planned to receive wide range of prophylactic lymphatic irradiation were selected to formulate 7-field IMRT plan,coplanar and non-coplanar VMAT plans respectively.The differences of dosimetric indexes of the three plans were compared,including conformity index(CI)and homogeneity index(HI)of target areas.Several indexes of organs-at-risk,including the Dmean,V5,V10,V20,V30 of lungs,the V30 and V40 of heart,the Dmax of spine cord were also compared.Meanwhile,treatment time and monitor units(MU)of three techniques were recorded for comparing the implementation efficiency.Results The HI and the V20 of lungs in coplanar and non-coplanar VMAT plans were superior to those in IMRT plan;the V5 of lungs in non-coplanar VMAT and IMRT plans were superior to those in coplanar VMAT plan;the Dmean and V10 of lungs in non-coplanar VMAT plans were superior to those in other plans.Compared to VMAT plans,the IMRT plans required the longest treatment time and highest MU.Conclusion Non-coplanar VMAT can improve the dose distribution and significantly shorten the treatment time compared with IMRT.It is recommended in prophylactic irradiation for lymph nodes of esophageal cancer.

关 键 词：食管癌 淋巴结预防照射 容积旋转调强 非共面 

分 类 号：R735.1[医药卫生—肿瘤]