不同子野面积参数对胃癌静态调强放疗计划的影响研究  

Effects of different subfield area parameters on static intensity-modulated radiation therapy of gastric cancer

作　　者：王继平 杨志勇 吕文天 罗云蔓 杨国栋 徐开 王萍[2] WANG Ji-ping;YANG Zhi-yong;LYU Wen-tian;LUO Yun-man;YANG Guo-dong;XU kai;WANG Ping(Radiotherapy Department,Huanggang Central Hospital of Yangtze University,Huanggang 438000,Hubei Province,China;Oncology Department,Huanggang Central Hospital of Yangtze University,Huanggang 438000,Hubei Province,China)

机构地区：[1]长江大学附属黄冈市中心医院放疗科,湖北黄冈438000 [2]长江大学附属黄冈市中心医院肿瘤科,湖北黄冈438000

出　　处：《医疗卫生装备》2022年第2期41-46,共6页Chinese Medical Equipment Journal

基　　金：湖北省卫生计划生育委员会科研项目(WJ2017 M243)。

摘　　要：目的:研究最小子野面积参数对胃癌静态调强放疗计划的影响,为临床计划合理设置最小子野面积提供参考。方法:选取某院拟行调强放疗的10例胃癌患者,对每例患者均采用Pinnacle39.10计划系统设计静态7野调强放疗计划,最小子野机器跳数均设置为7 MU,最小子野面积分别设置为4、7、10、15、20、25、30、35、40和50 cm^(2),并采用直接机器子野优化(direct machine parameter optimization,DMPO)方法进行逆向优化,每例患者共得到10个放疗计划。将最小子野面积设置为4 cm^(2)作为对照,通过剂量体积直方图(dose volume histogram,DVH)评估不同最小子野面积的调强放疗计划间患者靶区及危及器官的剂量学差异。采用SPSS 20.0软件进行统计学分析。结果:与最小子野面积设置为4 cm^(2)时相比,最小子野面积设置为15和20 cm^(2)时,靶区的适形度和均匀度较好,总子野数和机器跳数较少,靶区和危及器官的剂量学参数较优。结论:采用Pinnacle39.10计划系统设计胃癌静态调强放疗计划时,建议将最小子野面积设置为15和20 cm^(2),以得到更优质的计划方案,同时提高治疗效率。Objective To study the influences of the minimum subfield area parameters on the static intensity-modulated radiation therapy(IMRT)for gastric cancer,and to provide a reference for rational setting of the minimum subfield area for clinical planning.Methods Ten gastric cancer patients to be treated with IMRT were selected from some hospital,and a static 7-field IMRT plan was designed for each patient using the Pinnacle39.10 planning system.With 7 MU the minimum subfield areas were set to 4,7,10,15,20,25,30,35,40 and 50 cm^(2),respectively,and the direct machine parameter optimization(DMPO)method was applied to inverse optimization to obtain a total of 10 radiotherapy plans for each patient.With the minimum subfield area of 4 cm^(2) as a control the dose volume histogram(DVH)was used to assess the dosimetric differences in patient target areas and organs at risk between IMRT plans with different minimum subfield areas.Statistical analysis was carried out with SPSS 20.0 software.Results The minimum subfield areas of 15 and 20 cm^(2) gained advantages over that of 4 cm^(2) in conformity index,homogeneity index,lower numbers of subfields and monitor units and the dosimetric parameters of the target areas and organs at risk.Conclusion When designing a static IMRT plan for gastric cancer using the Pinnacle39.10 planning system,it is recommended that the minimum subfield area be set as 15 and 20 cm^(2) to obtain an effective plan and improved treatment efficiency.

关 键 词：最小子野面积 胃癌 调强放疗 静态调强放疗 剂量学 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]