IMRT和VMAT技术在全脑全脊髓放射治疗中靶区、骨髓及重要危及器官剂量差异分析  

Analysis of Dose Difference Between IMRT and VMAT to Target Area,Bone Marrow and Critical Organ-at-risk in Craniospinal Irradiation

作　　者：谷美林 时昌立 张帆[2] 文海英 罗俊波 GU Meilin;SHI Changli;ZHANG Fan(Henan General Hospital of Chinese People's Armed Police Force,Zhengzhou,450000)

机构地区：[1]中国人民武装警察部队河南省总队医院,450000 [2]郑州大学第五附属医院,450000

出　　处：《实用癌症杂志》2022年第8期1378-1380,1384,共4页The Practical Journal of Cancer

摘　　要：目的研究IMRT和VMAT技术在全脑全脊髓放射治疗中靶区、骨髓及重要危及器官剂量差异。方法选取接受全脑全脊髓放射治疗的84例患者作为研究对象,根据患者放疗技术分为A组(n=42)和B组(n=42),A组患者接受调强放射治疗(IMRT)技术放疗,B组患者接受容积调强弧形放疗(VMAT)技术放疗。对比两组患者靶区适形指数、均匀指数;对比靶区、骨髓交界处以及重要危机器官剂量。结果与A组患者相比,B组患者HI和靶区体积显著下降,CI显著升高,差异具有统计学意义(P<0.05);与A组患者相比,B组患者脑脊髓和胸腰脊髓参数显著更低,差异具有统计学意义(P<0.05);与A组患者相比,B组患者心脏、食管、甲状腺、小肠、肾脏、肝脏以及肺器官剂量,差异有统计学意义(P<0.05)。结论全脑全脊髓放射治疗,与IMRT相比,VMAT在治疗中的靶区、骨髓及重要危及器官剂量更加均匀。Objective To analyze the dose difference between intensity modulated radiotherapy(IMRT)and volumetric modulated arc therapy(VMAT)to target area,bone marrow and critical organ-at-risk in craniospinal irradiation.Methods 84 patients receiving craniospinal irradiation were enrolled,and divided into 2 groups according to different radiotherapy methods.Group A(n=42)received IMRT,while group B(n=42)received VMAT.The heterogeneous index(HI)and conformal index(CI),radiation doses to target area,bone marrow junction,and critical organ-at-risk were compared between the 2 groups.Results Compared with group A,group B had significantly decreased HI and target volume,and increased CI,with statistical difference(P<0.05).The cerebrospinal cord and thoracolumbar spinal cord parameters in group B were significantly lower than those in group A,with statistical significance(P<0.05).The doses to organ-at-risk including heart,esophagus,thyroid,small intestine,kidney,liver and lung were significantly lower in group B than in group A,with statistical difference(P<0.05).Conclusion Compared with IMRT,application of VAMT in craniospinal irradiation achieves more equivalent uniform irradiation dose to target area,bone marrow and critical organ-at-risk.

关 键 词：VMAT IMRT 全脑全脊髓放射 靶区 骨髓 

分 类 号：R73-36[医药卫生—肿瘤]