周围型肺癌立体定向放射治疗中采用实体肿瘤靶区推量技术的可行性研究—基于剂量学分析  

A feasible study of boosting target dose for peripheral lung cancer patients undergoing stereotactic body radiotherapy:a dosimetric analysis

作　　者：黄宝添[1] 林佩贤[2] HUANG Baotian;LIN Peixian(Department of Radiation Oncology,Cancer Hospital of Shantou University Medical College,Shantou 515041,China;Department of Nosocomial Infection Management,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院附属肿瘤医院放疗科,广东汕头515041 [2]汕头大学医学院第二附属医院医院感染管理科,广东汕头515041

出　　处：《中国医学物理学杂志》2023年第3期272-277,共6页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(81602667);汕头市医疗卫生科技计划项目(汕府科[2022]88号)。

摘　　要：目的:通过研究周围型肺癌立体定向放射治疗中提高肿瘤靶区最高剂量对剂量限制参数和正常器官剂量的影响,探讨使用实体肿瘤靶区推量技术的可行性,为临床治疗提供剂量学参考依据。方法:收集19例周围型早期肺癌患者的CT图像资料,重新设计放射治疗计划,初始治疗计划在满足放射治疗肿瘤协作组(RTOG)0915号报告关于剂量限制参数的情况下,以2 Gy的剂量爬升梯度分别对肿瘤靶区进行提量,共得到5组治疗计划。结果:5组计划的剂量限制参数均能满足RTOG0915号报告要求。5组计划的剂量限制参数和正常器官剂量无显著差异,但是肿瘤靶区最高剂量存在显著差异(P<0.05),最高和最低剂量组剂量差异可达6.6 Gy。结论:提高肿瘤靶区最高剂量对剂量限制参数和正常器官剂量没有显著影响。由于提高靶区内最高剂量会直接影响肿瘤的局部控制率,因此在满足剂量限制参数的前提下,建议使用实体肿瘤靶区推量技术以提高肿瘤靶区内的最高剂量。Objective To explore the feasibility of tumor dose boosting strategy by investigating the effects of boosting the maximum dose in the target on dose-restricting parameters and normal tissue doses for peripheral lung cancer patients undergoing stereotactic body radiotherapy(SBRT),thereby providing a dosimetric reference basis for clinical treatment.Methods The CT datasets from 19 patients with peripheral lung cancer were included for treatment replanning.The doserestricting parameters of the initial treatment plans were designed to meet the requirement of Radiation Therapy Oncology Group(RTOG)0915 report,and then another 4 groups of plans were designed by boosting the maximum dose in the target at a 2 Gy gradient.Results The dose-restricting parameters of the 5 groups of plans met the requirement of RTOG 0915 report.The dose-restricting parameters and normal tissue doses did not differ significantly among the 5 groups of plans.However,the maximum dose in the target differed by up to 6.6 Gy(P<0.05).Conclusion Boosting the tumor dose does not affect the dose-restricting parameters and normal tissue doses for lung cancer patients undergoing SBRT.As the maximum dose is reported to be associated with local control,a strategy of tumor dose boosting is recommended in clinical practice for increasing the maximum dose in the target under the premise of meeting the dose-restricting requirement.

关 键 词：周围型肺癌 立体定向放射治疗 肿瘤靶区推量 可行性 剂量学 

分 类 号：R734.2[医药卫生—肿瘤] R815.6[医药卫生—临床医学]