依据不同ICRP报告计算儿童全中枢神经系统放疗患者体内有效剂量的变化  

Comparion of Effective Dose in Pediatric Patients with Craniospinal Irradiation According to Different ICRP Report

作　　者：姚杏红 李勇 张怀文[2] 廖雄飞 YAO Xinghong;LI Yong;ZHANG Huaiwen(Sichuan Cancer Hospital,Chengdu,610041)

机构地区：[1]四川省肿瘤医院电子科技大学医学院,610041 [2]江西省肿瘤医院,610041

出　　处：《实用癌症杂志》2022年第2期345-348,共4页The Practical Journal of Cancer

摘　　要：目的对比依据ICRP 60号和ICRP 103号报告给出的器官组织权重因子计算儿童全中枢神经系统放疗(CSI)患者体内有效剂量的变化。方法选取已接受全中枢神经系统放射治疗的20例儿童患者,在Tomotherapy和Eclipse计划系统中分别重新设计螺旋断层放疗(HT)计划和多中心放疗(M-ISO)计划。统计两组计划中各危及器官的受量情况,对20例患者共40个调强治疗计划分别运用ICRP 60号和ICRP 103号报告计算患者体内的有效剂量,运用配对t检验比较ICRP新、旧版本报告计算的有效剂量的差异。结果两组计划对危及器官的保护各有优势。与ICRP 60号报告相比,ICRP 103号报告对器官组织权重因子进行了调整,导致患者体内组织器官的有效剂量发生变化,针对CSI患者,有效剂量变化较大的组织器官包括唾液腺、膀胱、乳腺、肝脏、食管、甲状腺、大脑和剩余组织;同时患者体内的总有效剂量也改变较大,HT和M-ISO技术中患者体内的有效剂量平均增高11.8%和10.5%。结论新、旧版本ICRP报告在组织器官权重上有较大差异;针对CSI患者,根据ICRP 103号报告计算得到的患者总有效剂量高于根据ICRP 60号报告计算的结果。Objective To compare the effective dose of pediatric craniospinal irradiation(CSI)calculated according to the tissue weighting factors in ICRP 60 and ICRP 103.Methods 20 pediatric patients with craniospinal irradiation were selected.For these patients,new treatment plans were designed with helical tomotherapy(HT)and multi-isocenter(M-ISO)technology in 2 different treatment planning system(TPS),Tomotherapy and Eclipse.Statistics of the dose for the organs at risk were collected.The effective doses in the 20 patients with 40 treatment plans were calculated respectively according to ICRP 60 and ICRP 103.Paired T test was used to compare the difference between the effective doses calculated with the new and old ICRP reports.Results HT and M-ISO plans had different advantages in the protection of the OARs.Compared with the ICRP 60,the tissue weighting factors were regulated in ICRP 103,which resulting in the changed effective doses of organs.For CSI patients,the effective doses vary greatly in salivary glands,bladder,breast,liver,esophagus,thyroid,brain and residual tissue.At the same time,the total effective dose in these patients also changed significantly,with an average increase of 11.8%in HT and 10.5%in M-ISO.Conclusion There is a great difference in the tissue weighting factors between the new and old ICRP reports.For CSI patients,the total effective dose calculated according to ICRP 103 was higher than that calculated according to ICRP 60.

关 键 词：有效剂量 国际放射防护委员会 螺旋断层放疗 多中心放疗 全中枢神经系统放疗 

分 类 号：R730.55[医药卫生—肿瘤]