VMAT和IMRT技术在NSCLC靶区及危及器官中剂量参数差异性的分析  

Analysis of Difference of Dose Parameters Between VMAT and IMRT in NSCLC Target Area and Organs at Risk

作　　者：张林 向森 孟强 ZHANG Lin;XIANG Seng;MENG Qiang(Zhumadian Central Hospital,Zhumadian,463000)

机构地区：[1]河南省驻马店市中心医院,463000

出　　处：《实用癌症杂志》2023年第2期263-265,269,共4页The Practical Journal of Cancer

摘　　要：目的比较容积弧形调强放射治疗技术(volumetric modulated arc therapy,VMAT)和适形调强放射治疗技术(intensity modulated radiotherapy,IMRT)在非小细胞肺癌(non-small cell lung carcinoma,NSCLC)靶区及危及器官中的剂量参数差异。方法选取72例晚期NSCLC并接受放射治疗的患者,根据不同治疗计划将患者分为VMAT组38例和IMRT组34例,对比分析两组患者靶区剂量学参数和累计器官的剂量学参数差异。结果VMAT组PTV中D_(min)、D_(mean)、D_(max)均低于IMRT组,HI低于IMRT组,CI高于IMRT组,两组对比差异具有统计学意义(P<0.05)。VMAT组双肺的MLD以及不同剂量区V_(5)、V_(10)、V_(20)、V_(30)都要高于IMRT组,两组对比差异具有统计学意义(P<0.05);心脏方面的V_(30)与V_(40)两组无显著差异(P>0.05);脊髓D_(max)VMAT组高于IMRT组,两组对比差异具有统计学意义(P<0.05)。结论虽然VMAT计划的靶区剂量分布,适形度优于IMRT计划,但是两组的靶区剂量分布差异并不大,而且对于肺部MLD以及V_(5)、V_(10)等低剂量区都是IMRT计划更优。Objective To compare the difference of dose parameters between specific volume modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the target area and endangered organs of non-small cell lung cancer(NSCLC).Methods 72 patients with advanced NSCLC receiving radiotherapy were selected and divided into VMAT group(38 cases)and IMRT group(34 cases)according to different treatment plans.The difference of dosimetric parameters in target area and cumulative organs between the 2 groups was analyzed.Results D_(min),D_(mean),and D_(max) in the PTV of the VMAT group were lower than those of the IMRT group,HI was lower than that of the IMRT group,and CI was higher than that of the IMRT group(P<0.05).The MLD of both lungs and V_(5),V_(10),V_(20) and V_(30) in different dose areas in the VMAT group were higher than those in the IMRT group(P<0.05).There was no significant difference between the 2 groups in terms of heart V_(30) and V_(40)(P>0.05);the spinal cord D_(max)VMAT group was higher than that in the IMRT group(P<0.05).Conclusions Although the target dose distribution of VMAT plan is better than that of IMRT plan,there is no significant difference in the target dose distribution between the 2 groups,and IMRT plan is better for lung MLD,V_(5),V_(10) and other low-dose regions.

关 键 词：NSCLC 放射治疗 VMAT IMRT 剂量参数 

分 类 号：R734.2[医药卫生—肿瘤]