有无均整器模式对肝癌患者容积旋转调强放射治疗计划的剂量学影响  

DOSIMETRIC INFLUENCE OF FLATTENING FILTER VOLUMETRIC MODULATED ARC THERAPY VERSUS FLATTENING FILTER-FREE VOLUMETRIC MODULATED ARC THERAPY ON RADIOTHERAPY PLANNING FOR PATIENTS WITH LIVER CANCER

作　　者：史子柯 马霄云 张雁山 金雪玲 寇海瑞 吴嘉明 SHI Zike;MA Xiaoyun;ZHANG Yanshan;JIN Xueling;KOU Hairui;WU Jiaming(Department of Radiation Physics, Gansu Wuwei Tumor Hospital Heavy Ion Center, Wuwei 733000, China)

机构地区：[1]甘肃省武威肿瘤医院重离子中心放射物理室,甘肃武威733000

出　　处：《精准医学杂志》2021年第6期492-495,500,共5页Journal of Precision Medicine

基　　金：甘肃省科技计划项目(重点研发计划)(19YF3FH-001)。

摘　　要：目的比较直线加速器在6 MV X射线下对肝癌患者有均整过滤器(FF)模式下容积旋转调强放射治疗(FF-VMAT)和无均整过滤器(FFF)模式下VMAT(FFF-VMAT)计划的剂量学影响。方法选取2020年8月—2021年4月于甘肃省武威肿瘤医院确诊为肝癌并拟行放疗的患者10例,采用6 MV X射线分别设计FF-VMAT和FFF-VMAT计划,比较两种模式下治疗计划的靶区适形度(CI)和剂量均匀性(HI)、正常肝组织受量、危及器官(OAR)受量以及加速器总跳数和出束时间。结果FF-VMAT和FFF-VMAT计划靶区剂量分布都能满足临床处方剂量的要求。两种计划加速器出束时间比较差异有显著性(t=13.611,P<0.001),但靶区CI、HI、正常肝组织和OAR的受量以及加速器跳数比较差异均无显著性(P>0.05)。结论FF-VMAT和FFF-VMAT计划均能满足临床治疗需要,但FFF-VMAT计划实际出束时间更短,治疗效率更高,因此FFF-VMAT计划应用于肝癌的临床放疗更具优势。Objective To investigate the dosimetric influence of flattening filter volumetric modulated arc therapy(FF-VMAT)versus flattening filter-free volumetric modulated arc therapy(FFF-VMAT)on radiotherapy planning for patients with liver cancer using a linear accelerator with 6 MV X-ray.Methods A total of 10 patients who were diagnosed with liver cancer in Wuwei Tumor Hospital of Gansu Province from August 2020 to April 2021 and planned to undergo radiotherapy were enrolled,and 6 MV X-ray was used to design FF-VMAT and FFF-VMAT plans.The two treatment plans were compared in terms of conformity index(CI)and homogeneity index(HI)of target volume,dose distribution in normal liver tissue and organ at risk(OAR),and monitor units and beam-on time of the accelerator.Results The target dosimetric distribution of both FF-VMAT and FFF-VMAT plans can meet the clinical requirements for prescribed dose.There was a significant difference in the beam-on time of the accelerator between the two plans(t=13.611,P<0.001),while there were no significant differences between the two plans in CI and HI of target volume,dose distribution in normal liver tissue and OAR,and number of monitor units(P>0.05).Conclusion Both FF-VMAT and FFF-VMAT plans can meet the needs of clinical treatment,but FFF-VMAT plan has a shorter beam-on time and a higher treatment efficiency,and therefore,FFF-VMAT plan has more advantages when applied in clinical radiotherapy for liver cancer.

关 键 词：肝肿瘤 放射疗法 计算机辅助 容积旋转调强 无均整器模式 危及器官剂量 剂量效应关系 辐射 粒子加速器 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]