两种调强放射治疗技术应用于Ⅰ期胸上段食管癌的剂量学比较  

Dosimetric Comparison of Two Intensity Modulated Radiotherapy Techniques for StageⅠUpper Thoracic Esophageal Cancer

作　　者：林斌伟 郑旭海[1] 高峰[1] 黄丹[2] Lin Binwei;Zheng Xuhai;Gao Feng;Huang Dan(Department of Oncology,Mianyang Central Hospital,Mianyang Sichuan 621000,China;Department of Radiology,Mianyang Central Hospital,Mianyang Sichuan 621000,China)

机构地区：[1]绵阳市中心医院肿瘤科,四川绵阳621000 [2]绵阳市中心医院放射科,四川绵阳621000

出　　处：《医疗装备》2022年第18期6-9,共4页Medical Equipment

基　　金：绵阳市中心医院院级课题(2019YJ18)。

摘　　要：目的比较容积弧形旋转调强放射治疗(VMAT)和固定野静态调强放射治疗(sIMRT)应用于Ⅰ期胸上段食管癌的剂量学差异。方法选择2021年6—9月于绵阳市中心医院行根治性放射治疗的8例Ⅰ期胸上段食管癌(均为鳞癌)患者为研究对象,采用Monaco 5.11治疗计划系统分别制定VMAT和sIMRT计划,比较两种计划靶区和危及器官(双肺、脊髓、心脏、甲状腺)的剂量学参数和机器跳数。结果关于计划肿瘤区(P-GTV),VMAT计划的适形指数(CI)和均匀性指数(HI)均优于sIMRT计划,近似最小剂量(D_(98%))高于sIMRT计划,近似最大剂量(D_(2%))低于sIMRT计划,差异均有统计学意义(P<0.05);关于计划靶区(PTV),VMAT计划的CI和HI均优于sIMRT计划,D_(2%)、平均剂量(D_(mean))均低于sIMRT计划,差异有统计学意义(P<0.05)。VMAT计划的双肺V_(5)(V_(x)表示x Gy照射剂量所覆盖的体积占总体积的比值)、V_(10)、V_(13)、平均肺剂量(MLD)均高于sIMRT计划,差异有统计学意义(P<0.05);两种计划的脊髓D_(2%)和甲状腺V_(50)比较,差异无统计学意义(P>0.05)。在VMAT计划中,有2例患者心脏V_(20)>0,分别为0.01%和2.58%;VMAT计划的心脏V_(30)、V_(40)、V_(50)以及sIMRT计划的心脏V_(20)、V_(30)、V_(40)、V_(50)均为0。结论与sIMRT比较,Ⅰ期胸上段食管癌患者可能更适合采用VMAT技术进行治疗。Objective The dosimetric differences between volumetric modulated arc therapy(VMAT)and static intensity modulated radiotherapy(sIMRT)for stageⅠthoracic esophageal cancer were compared.Methods Eight patients admitted to Mianyang Central Hospital from June to September 2021 with stageⅠupper thoracic esophageal cancer(all squamous cell carcinoma)undergoing radical radiotherapy were selected as the study subjects.VMAT and sIMRT plans were formulated by the Monaco 5.11 treatment planning system,and dosimetric parameters and machine hops were compared between the two plans.Results In the planned tumor area(P-GTV),compared with the sIMRT plan,the results of conformation index(CI)and homogeneity index(HI)in the VMAT plan were better,with higher approximate minimum dose(D_(98%))and lower approximate maximum dose(D_(2%)),and the differences were statistically significant(P<0.05).In planning target area(PTV),compared with sIMRT plan,VMAT plan had better CI and HI,lower D_(2%) and mean dose(D_(mean)),and the differences were statistically significant(P<0.05).Meanwhile,compared with the sIMRT plan,the VMAT plan had higher double lung V_(5)(V_(x) represents the ratio of the volume covered by the x Gy irradiation dose to the total volume),V_(10),V_(13),and mean lung dose(MLD),and the difference was statistically significant(P<0.05);There was no significant difference in D_(2%) of spinal cord and V_(50) of thyroid between the two plans(P>0.05).In the VMAT plan,there were 2 patients with heart V_(20)>0,and the values were 0.01%and 2.58%respectively;The values of heart V_(30),V_(40),V_(50) in VMAT plan and heart V_(20),V_(30),V_(40),V_(50) in sIMRT plan are 0.Conclusion Compared with sIMRT,VMAT may be more suitable for the treatment of stageⅠupper thoracic esophageal cancer.

关 键 词：食管癌 容积弧形旋转调强放射治疗 固定野静态调强放射治疗 剂量学 

分 类 号：R735.1[医药卫生—肿瘤]