通量平滑度对肺癌放疗物理剂量和生物剂量的影响  

Dosimetric and Radiobiological Evaluation of Fluence-smoothing on Lung Cancer Treated with Intensity Modulated Radiotherapy

作　　者：彭圣贤 庞亚 刘悦 王东[1] PENG Shengxian;PANG Ya;LIU Yue(Zigong First People's Hospital,Zigong,643000)

机构地区：[1]四川省自贡市第一人民医院,643000

出　　处：《实用癌症杂志》2023年第1期167-171,共5页The Practical Journal of Cancer

摘　　要：目的 比较通量平滑度对肺癌调强放疗(intensity modulated radiotherapy, IMRT)剂量学参数和放射生物学参数的影响,为肺癌IMRT计划设计提供参考。方法 选择肺癌患者20例,基于Eclipse v13.6计划系统对每位患者先使用默认的通量平滑值Smooth 40 30(MLC运动方向为40,MLC垂直方向为30)制定IMRT计划。在相同的优化条件下,改变通量平滑X、Y值分别为Smooth 0 0、Smooth 20 10、Smooth 60 50、Smooth 80 70、Smooth 100 100重新进行计划设计和评估。评估计划的剂量学参数和放射生物学参数以及机器跳数(MU)。结果 Smooth 40 30通量组与其他组相比,CI有统计学差异(P<0.05),HI除Smooth 100 100有统计学差异外,其他组均无统计学差异(P>0.05),Smooth 100 100通量组危及器官肺V_(5)、V_(20)、V_(30),心脏V_(30)、V_(40)、D_(mean),脊髓D_(max)受量均高于Smooth 40 30通量组(P<0.05),通量平滑值在Smooth 60 50及以上危及器官受量有上升趋势。随着通量平滑值增大,MU减小明显,肿瘤控制概率(TCP)与正常组织并发症概率(NTCP)变化平稳。结论 在肺癌IMRT放疗中,结合剂量学参数和放射生物学参数以及MU数,推荐选取Smooth 60 50为通量平滑值。Objective The effect of flux smoothness on lung cancer intensity modulated radiotherapy(IMRT) dosimetry parameters and radiobiological parameters were compared to provide reference for the design of lung cancer IMRT plans.Methods 20 lung cancer patients were selected for retrospective analysis, based on The Eclipse v13.6 planning system first uses the default flux smoothing value Smooth 40 30(X=40,Y=30) for each patient to design an IMRT plan.Under the same optimized conditions, change the fluence-smoothing X,Y values to Smooth 0 0,Smooth 20 10,Smooth 60 50,Smooth 80 70,Smooth 100 100 to re-design and evaluate the plans.The dosimetry and radiobiological parameters and monitor units(MU) of all plans were evaluated.Results Compared with the other groups in the Smooth 40 30 fluence group, CI had statistical difference(P<0.05).Except for Smooth 100 100,there was no statistical difference in HI in the other groups(P>0.05).The Smooth 100 100 fluence group endangered organs: lung V_(5),V_(20),V_(30),heart V_(30),V_(40),D_(mean),and spinal cord D_(max)were all higher than the Smooth 40 30 flux group(P<0.05).There was an upward trend in organ intake as the fluence-smoothing value increases in the value of Smooth 60 50 above, the MU decreases significantly, and the tumor control probability(TCP) and normal tissue complication probability(NTCP) did not change much as the smooth increased.Conclusion In IMRT radiotherapy for lung cancer, combining dosimetry parameters, radiobiological parameters with MU number, it is recommended to select Smooth 60 50 as the flux smoothing value.

关 键 词：肺癌 调强放疗 通量平滑 放射生物 剂量 ECLIPSE 

分 类 号：R734.2[医药卫生—肿瘤]