宫颈癌术后盆腔HT、sIMRT、VMAT计划的低剂量照射区比较  

Comparison of low dose irradiation areas of HT,sIMRT and VMAT plans for pelvic cavity after cervical cancer surgery

作　　者：王洋 刘晓超 杨值 高红祥 WANG Yang;LIU Xiaochao;YANG Zhi;GAO Hongxiang(Radiotherapy Department,Chang'an Hospital,Xi'an 710016;Radiotherapy Department,Boao Evergrande International Hospital,Qionghai 571400,China)

机构地区：[1]长安医院放疗科,陕西西安710016 [2]海南博鳌恒大国际医院放疗科,海南琼海571400

出　　处：《临床医学研究与实践》2023年第1期100-103,共4页Clinical Research and Practice

摘　　要：目的比较宫颈癌术后盆腔螺旋断层放疗(HT)、静态调强放疗(sIMRT)及容积旋转调强放疗(VMAT)计划的低剂量照射区。方法选取10例宫颈癌术后患者,分别在安科瑞TomoH治疗计划系统、西门子Oncentra治疗计划系统及瓦里安Eclipse治疗计划系统上以相同剂量限值完成四组计划设计:A组为TomoH的HT治疗计划、B组为Oncentra的sIMRT治疗计划、C组为Eclipse的sIMRT治疗计划、D组为Eclipse的VMAT治疗计划。记录计划靶区(PTV)的D_(2%)、D_(98%)、适型指数(PCI)、剂量均匀性指数(HI)各参数值;记录小肠、膀胱的D_(2%)、V_(30)、V_(40)、V_(50),直肠的D_(2%)、V_(40)、V_(50)各参数值,以及10%、20%、30%、40%等剂量线包绕的低剂量照射体积。结果A组的D_(2%)、D_(98%)优于B、C组,PCI优于C组,HI优于B、C、D组,差异具有统计学意义(P<0.05)。A组的小肠V_(40)劣于C组,直肠V_(40)优于D组,直肠V_(50)劣于B组,膀胱D_(2%)优于B、C组,膀胱V_(30)劣于C组,膀胱V_(40)劣于C、D组,差异具有统计学意义(P<0.05)。A组中10%、20%、30%、40%等剂量线包绕的体积与B、C、D组比较,差异无统计学意义(P>0.05)。结论HT计划在靶区剂量分布上显著优于其他计划,在充分保证靶区剂量的同时不增加周围正常组织的受量,且没有增加低剂量照射区的范围。Objective To compare the low dose irradiation areas of helical tomotherapy(HT),static intensity-modulated radiotherapy(sIMRT)and volumetric modulated arc therapy(VMAT)plans for pelvic cavity after cervical cancer surgery.Methods Ten postoperative patients with cervical cancer were selected to complete the four groups of plan design with the same dose limit on the accuray TomoH treatment planning system,Siemens Oncentra treatment planning system and Varian Eclipse treatment planning system:group A was TomoH’s HT treatment plan,group B was Oncentra’s sIMRT treatment plan,group C was Eclipse’s sIMRT treatment plan,and group D was Eclipse’s VMAT treatment plan.Each parameter value of D_(2%),D_(98%),paddick conformity index(PCI)and heterogeneity index(HI)of planned target volume(PTV)were recorded;the D_(2%),V_(30),V_(40) and V_(50) of small intestine and bladder,D_(2%),V_(40) and V_(50) of rectum,and the low dose irradiation volume wrapped by 10%,20%,30%and 40%isodose lines were recorded.Results The D2%and D_(98%) of the group A were better than those of the group B and C,PCI was better than that of the group C,HI was better than that of the group B,C and D,and the differences were statistically significant(P<0.05).The V_(40) of small intestine in the group A was inferior to that in the group C,the V_(40) of rectum was superior to that in the group D,the V_(50) of rectum was inferior to that in the group B,the D_(2%) of bladder was superior to that in the group B and C,the V_(30) of bladder was inferior to that in the group C,and the V_(40) of bladder was inferior to that in the group C and D,and the differences were statistically significant(P<0.05).The volume of 10%,20%,30%and 40%isodose line in the group A were not significantly different from those in the group B,C and D(P>0.05).Conclusion HT plan has significantly better than other plans in the target dose distribution,while fully ensuring the target dose does not increase the surrounding normal tissue dose,and does not increase the scope of low dose irra

关 键 词：宫颈癌 螺旋断层放疗 静态调强放疗 容积旋转调强放疗 低剂量照射 

分 类 号：R737.33[医药卫生—肿瘤]