舌癌双弧容积旋转调强放射治疗两种射野方式的剂量学研究  

Dosimetric study of two kinds of field modes in dual-arc volume modulated arc radiotherapy for tongue cancer

作　　者：郑莉萍[1] 毕帆 石慧烽[1] 涂文勇[1] ZHENG Li-ping;BI Fan;SHI Hui-feng(Department of Oral Maxillofacial Head and Neck Oncology,Shanghai Ninth People’s Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine,National Clinical Research Center of Oral Diseases,Shanghai Research Institute of Stomatology&Shanghai Key laboratory of Stomatology,Shanghai 200011,China;不详)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,国家口腔疾病临床医学研究中心,上海市口腔医学研究所,上海市口腔医学重点实验室,上海200011

出　　处：《中国医学装备》2022年第1期40-44,共5页China Medical Equipment

基　　金：上海交通大学医学院技术转移推广项目(ZT201807)“口腔放射治疗在体位置与剂量验证装置”。

摘　　要：目的:探讨舌癌在容积旋转调强治疗(VMAT)时射野选择的可行性与优劣性,比较舌癌术后单野双弧和双野双弧两种计划的射野设置方式。方法:选取医院收治的20例舌癌术后患者,由同一位物理师根据同一位经验丰富的医生勾画的临床靶区对患者在放射治疗计划系统中设计单野双弧和双野双弧VMAT计划,对两种计划的靶区剂量学、脊髓最大量、喉、右腮腺和咽缩肌等危及器官(OAR)的平均受量、计划机器跳数(MU)和计划计算时间等参数进行统计分析比较。结果:单野双弧计划的D_(98)、D_(50)、D_(2)、D_(5)及D_(mean)剂量均匀性指数(HI)和靶区适形度(CI)均优于双野双弧计划,除D_(2)外,差异均有统计学意义(t=5.055,t=-3.941,t=-3.935,t=-3.968,t=-4.274,t=3.82;P<0.05);单野双弧计划的脊髓最大量、喉、右腮腺和咽缩肌的平均受量均低于双野双弧计划,其中喉和咽缩肌两种计划比较差异具有统计学意义(t=-7.507,t=-4.003;P<0.05);单野双弧计划的机器跳数和计划计算时间均低于双野双弧计划,两者比较差异有统计学意义(t=-5.515,t=-13.568;P<0.05)。结论:单野双弧计划较双野双弧计划节省了计划计算时间和加速器跳数,单野双弧的设计方式更能发挥Monaco计划系统智能多叶准直器(MLC)的优势。Objective:To explore the feasibility,advantages and disadvantages of choosing field in volumetric modulated arc therapy(VMAT)for tongue cancer,and compare the installation modes of two kinds of plans included signal-field dual arc and double-field dual arc after surgery of tongue cancer.Methods:20 patients with tongue cancer who admitted to hospital were enrolled in this study.According to the clinical target regions which were delineated by the same one doctor with rich experience,the same one physician designed VMAT plans of signal-field dual arc and double-field dual arc for patients in the radiotherapy plan system.The dosimetry of target region,the maximum dose of spinal cord,the average doses of organ at risk(OAR)included larynx,right parotid gland and pharyngeal constrictor,monitor unit(MU)and calculation time of plan between the two kinds of plans were statistically analyzed and compared.Results:The D_(98),D_(50),D_(2),D_(5),D_(mean),dose homogeneity index(HI)and conformity index(CI)of singlefield dual arc plan were better than those of double-field dual arc plan,and the differences of them except between two kinds of plans were significant(t=5.055,t=-3.941,t=-3.935,t=-3.968,t=-4.274,t=3.82,P<0.05),respectively.The maximum dose of spinal cord,and the average doses of larynx,right parotid gland and pharyngeal constrictor of signalfield dual arc plan were lower than those of double-field dual arc plan,and the differences of larynx and pharyngeal constrictor between two kinds of plans were significant(t=-7.507,t=-4.003,P<0.05).In addition,the MU and calculation time of plan of signal-field dual arc plan were significantly lower than those of double-field dual arc plan(t=-5.515,t=-13.568,P<0.05),respectively.Conclusion:Compared with double-field dual arc plan,signal-field dual arc plan saves the calculation time of plan and MU,and the designed mode of that can better take advantage of the intelligent multi-leaf collimator(MLC)of the Monaco planning system.

关 键 词：容积旋转调强 单野双弧 双野双弧 治疗计划系统 舌癌 

分 类 号：R814.2[医药卫生—影像医学与核医学]